This study was conducted in the 25-bed medical intensive care unit of Paris-Saclay university, Bicêtre hospital, from March to September 2018. It was approved by the institutional review board of our institution (Comité pour la protection des personnes Ile-de-France VII). Patients or their next of kin were informed about the study and accepted to participate.
Patients were included if they met all the following criteria: septic shock [7 (link)], continuous intravenous administration of NE, mechanical ventilation in the volume assist-control mode (Evita 4 or V500, Dräger, Lübeck, Germany), haemodynamic monitoring by a PiCCO2 device (PULSION Medical Systems, Feldkirchen, Germany), haemodynamic stability as defined by no change in the mean arterial pressure and in cardiac index (CI) > 10% for at least 30 min [2 (link)], decision of the attending physicians to decrease the dose of NE in order to reach a predefined target of mean arterial pressure (65–70 mmHg by default, 80–85 mmHg in previously hypertensive patients [8 (link)]). Patients were not included consecutively but depending on the availability of the investigators.
Patients were excluded in case of age < 18 years, pregnancy, head trauma (contraindication to PLR) and intra-abdominal hypertension [9 (link)] or venous compression stockings (both responsible for some false-negatives of the PLR test).
Patients were included if they met all the following criteria: septic shock [7 (link)], continuous intravenous administration of NE, mechanical ventilation in the volume assist-control mode (Evita 4 or V500, Dräger, Lübeck, Germany), haemodynamic monitoring by a PiCCO2 device (PULSION Medical Systems, Feldkirchen, Germany), haemodynamic stability as defined by no change in the mean arterial pressure and in cardiac index (CI) > 10% for at least 30 min [2 (link)], decision of the attending physicians to decrease the dose of NE in order to reach a predefined target of mean arterial pressure (65–70 mmHg by default, 80–85 mmHg in previously hypertensive patients [8 (link)]). Patients were not included consecutively but depending on the availability of the investigators.
Patients were excluded in case of age < 18 years, pregnancy, head trauma (contraindication to PLR) and intra-abdominal hypertension [9 (link)] or venous compression stockings (both responsible for some false-negatives of the PLR test).
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