{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T02:20:05Z","timestamp":1760149205902,"version":"build-2065373602"},"reference-count":51,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2023,7,21]],"date-time":"2023-07-21T00:00:00Z","timestamp":1689897600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004504","name":"Research Council of Lithuania","doi-asserted-by":"publisher","award":["S-MIP-23-79"],"award-info":[{"award-number":["S-MIP-23-79"]}],"id":[{"id":"10.13039\/501100004504","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Life"],"abstract":"<jats:p>Background: The passive leg-raising (PLR) test was developed to predict fluid responsiveness and reduce fluid overload. However, the hemodynamic response of healthy individuals to the PLR test and how it changes during the day, between the morning and evening, after individuals have consumed food and fluids, has not been profoundly explored. This study aimed to compare the systemic hemodynamic changes in healthy individuals between morning and evening PLR tests. Methods: In this study, the PLR test was performed twice a day. The first PLR test was performed between 08h00 and 09h00 in the morning, while the second PLR test was performed between 20h00 and 21h00 in the evening. Hemodynamic parameters were measured using an impedance cardiography monitor, and a cutoff value of a 10% increase in stroke volume (SV) during the PLR test was used to differentiate between preload responders and non-responders. Results: We included 50 healthy volunteers in this study. When comparing the morning and evening PLR test results, we found no PLR-induced differences in heart rate (\u22123 [\u22128\u20132] vs. \u22122 [\u22128\u20134] beats\/min, p = 0.870), SV (11 [5\u201322] vs. 12 [4\u201320] mL, p = 0.853) or cardiac output (0.7 [0.2\u20131.3] vs. 0.8 [0.1\u20131.4] L\/min, p = 0.639). We also observed no differences in the proportion of preload responders during the PLR test between the morning and evening (64% vs. 66%, p = 0.99). However, there was a moderate agreement between the two PLR tests (morning and evening) (kappa = 0.429, p = 0.012). There was a moderate correlation between the changes in SV between the two PLR tests (rs = 0.50, p &lt; 0.001). Conclusion: In young, healthy individuals, we observed no change in the systemic hemodynamic responsiveness to the PLR test between the morning and evening, without restriction of fluid and food intake.<\/jats:p>","DOI":"10.3390\/life13071606","type":"journal-article","created":{"date-parts":[[2023,7,24]],"date-time":"2023-07-24T00:57:30Z","timestamp":1690160250000},"page":"1606","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Differences in Hemodynamic Response to Passive Leg Raising Tests during the Day in Healthy Individuals: The Question of Normovolemia"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9365-9984","authenticated-orcid":false,"given":"Andrius","family":"Pranskunas","sequence":"first","affiliation":[{"name":"Department of Intensive Care Medicine, Lithuanian University of Health Sciences, Eiveniu g. 2, 50161 Kaunas, Lithuania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Egle","family":"Gulbinaite","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Medical Academy, Lithuanian University of Health Sciences, A. Mickeviciaus g. 9, 44307 Kaunas, Lithuania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aiste","family":"Navickaite","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Medical Academy, Lithuanian University of Health Sciences, A. Mickeviciaus g. 9, 44307 Kaunas, Lithuania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zivile","family":"Pranskuniene","sequence":"additional","affiliation":[{"name":"Institute of Pharmaceutical Technologies, Lithuanian University of Health Sciences, Sukileliu pr. 13, 50166 Kaunas, Lithuania"},{"name":"Department of Drug Technology and Social Pharmacy, Lithuanian University of Health Sciences, Sukileliu pr. 13, 50166 Kaunas, Lithuania"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2023,7,21]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"659","DOI":"10.1007\/s00134-008-0994-y","article-title":"Passive leg raising","volume":"34","author":"Monnet","year":"2008","journal-title":"Intensive Care Med."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1186\/s13054-014-0708-5","article-title":"Passive leg raising: Five rules, not a drop of fluid!","volume":"19","author":"Monnet","year":"2015","journal-title":"Crit. Care"},{"key":"ref_3","first-page":"773","article-title":"Brachial artery diameter changes associated with cardiopulmonary baroreflex activation in humans","volume":"258","author":"London","year":"1990","journal-title":"Am. J. Physiol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"311","DOI":"10.1007\/BF02581162","article-title":"Preclinical abnormality of left ventricular performance in patients with insulin-dependent diabetes mellitus","volume":"20","author":"Jermendy","year":"1983","journal-title":"Acta Diabetol. Lat."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"188","DOI":"10.1016\/j.atherosclerosis.2010.05.019","article-title":"Passive leg raising induced brachial artery dilation: Is an old technique a simpler method to measure endothelial function?","volume":"212","author":"Kamran","year":"2010","journal-title":"Atherosclerosis"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1007\/s00134-008-1293-3","article-title":"Passive leg raising for predicting fluid responsiveness: Importance of the postural change","volume":"35","author":"Jabot","year":"2009","journal-title":"Intensive Care Med."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"617","DOI":"10.1093\/bja\/aet590","article-title":"Fluid responsiveness: An evolution of our understanding","volume":"112","author":"Marik","year":"2014","journal-title":"Br. J. Anaesth."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"2000","DOI":"10.1378\/chest.121.6.2000","article-title":"Predicting fluid responsiveness in ICU patients: A critical analysis of the evidence","volume":"121","author":"Michard","year":"2002","journal-title":"Chest"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1935","DOI":"10.1007\/s00134-015-4134-1","article-title":"Passive leg raising for predicting fluid responsiveness: A systematic review and meta-analysis","volume":"42","author":"Monnet","year":"2016","journal-title":"Intensive Care Med."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"981","DOI":"10.1097\/CCM.0000000000001556","article-title":"Predicting Fluid Responsiveness by Passive Leg Raising: A Systematic Review and Meta-Analysis of 23 Clinical Trials","volume":"44","author":"Cherpanath","year":"2016","journal-title":"Crit. Care Med."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1862","DOI":"10.1097\/CCM.0000000000004617","article-title":"Fluid Overload and Mortality in Adult Critical Care Patients-A Systematic Review and Meta-Analysis of Observational Studies","volume":"48","author":"Messmer","year":"2020","journal-title":"Crit. Care Med."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1245","DOI":"10.1378\/chest.121.4.1245","article-title":"Changes in BP induced by passive leg raising predict response to fluid loading in critically ill patients","volume":"121","author":"Boulain","year":"2002","journal-title":"Chest"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"544","DOI":"10.1136\/emermed-2017-206836","article-title":"What is the normal haemodynamic response to passive leg raise? A study of healthy volunteers","volume":"35","author":"Elwan","year":"2018","journal-title":"Emerg. Med. J."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"961","DOI":"10.1161\/CIRCULATIONAHA.110.943019","article-title":"Endogenous circadian rhythm in vasovagal response to head-up tilt","volume":"123","author":"Hu","year":"2011","journal-title":"Circulation"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"141","DOI":"10.1007\/s10557-005-1048-0","article-title":"Comparison of impedance cardiography and thermodilution-derived measurements of stroke volume and cardiac output at rest and during exercise testing","volume":"19","author":"Scherhag","year":"2005","journal-title":"Cardiovasc. Drugs Ther."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"408","DOI":"10.4037\/ajcc2017488","article-title":"Measuring Stroke Volume: Impedance Cardiography vs. Phase-Contrast Magnetic Resonance Imaging","volume":"26","author":"Borzage","year":"2017","journal-title":"Am. J. Crit. Care"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"596","DOI":"10.1093\/bja\/aeu136","article-title":"Accuracy of impedance cardiography for evaluating trends in cardiac output: A comparison with oesophageal Doppler","volume":"113","author":"Lorne","year":"2014","journal-title":"Br. J. Anaesth."},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Kaszuba, E., Scheel, S., Odeberg, H., and Halling, A. (2013). Comparing impedance cardiography and echocardiography in the assessment of reduced left ventricular systolic function. BMC Res. Notes, 6.","DOI":"10.1186\/1756-0500-6-114"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"R37","DOI":"10.1186\/cc6822","article-title":"Ability of pleth variability index to detect hemodynamic changes induced by passive leg raising in spontaneously breathing volunteers","volume":"12","author":"Keller","year":"2008","journal-title":"Crit. Care"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"416","DOI":"10.1136\/emermed-2020-209771","article-title":"Non-invasive assessment of fluid responsiveness to guide fluid therapy in patients with sepsis in the emergency department: A prospective cohort study","volume":"38","author":"Koopmans","year":"2021","journal-title":"Emerg. Med. J."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1186\/s13613-016-0225-6","article-title":"Passive leg raise testing effectively reduces fluid administration in septic shock after correction of non-compliance to test results","volume":"7","author":"Rameau","year":"2017","journal-title":"Ann. Intensive Care."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"e15216","DOI":"10.14814\/phy2.15216","article-title":"To identify normovolemia in humans: The stroke volume response to passive leg raising vs. head-down tilt","volume":"10","author":"Sejersen","year":"2022","journal-title":"Physiol. Rep."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"464","DOI":"10.1111\/j.1399-6576.2009.02175.x","article-title":"Functional intravascular volume deficit in patients before surgery","volume":"54","author":"Jorgensen","year":"2010","journal-title":"Acta Anaesthesiol. Scand."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1089","DOI":"10.1034\/j.1399-6576.2002.460906.x","article-title":"Compensatory fluid administration for preoperative dehydration--does it improve outcome?","volume":"46","author":"Holte","year":"2002","journal-title":"Acta Anaesthesiol. Scand."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"835","DOI":"10.1093\/bja\/aet478","article-title":"Preoperative fasting does not affect haemodynamic status: A prospective, non-inferiority, echocardiography study","volume":"112","author":"Muller","year":"2014","journal-title":"Br. J. Anaesth."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"306","DOI":"10.1111\/anae.12560","article-title":"A prospective observational study of stroke volume responsiveness to a passive leg raise manoeuvre in healthy non-starved volunteers as assessed by transthoracic echocardiography","volume":"69","author":"Godfrey","year":"2014","journal-title":"Anaesthesia"},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Chopra, S., Thompson, J., Shahangian, S., Thapamagar, S., Moretta, D., Gasho, C., Cohen, A., and Nguyen, H.B. (2019). Precision and consistency of the passive leg raising maneuver for determining fluid responsiveness with bioreactance non-invasive cardiac output monitoring in critically ill patients and healthy volunteers. PLoS ONE, 14.","DOI":"10.1371\/journal.pone.0222956"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1186\/s13049-017-0370-4","article-title":"The haemodynamic dilemma in emergency care: Is fluid responsiveness the answer? A systematic review","volume":"25","author":"Elwan","year":"2017","journal-title":"Scand. J. Trauma. Resusc. Emerg. Med."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"364","DOI":"10.1378\/chest.12-1274","article-title":"The use of bioreactance and carotid Doppler to determine volume responsiveness and blood flow redistribution following passive leg raising in hemodynamically unstable patients","volume":"143","author":"Marik","year":"2013","journal-title":"Chest"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"R195","DOI":"10.1186\/cc8195","article-title":"Changes in stroke volume induced by passive leg raising in spontaneously breathing patients: Comparison between echocardiography and Vigileo\/FloTrac device","volume":"13","author":"Biais","year":"2009","journal-title":"Crit. Care"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"669","DOI":"10.1111\/j.1553-2712.2003.tb00054.x","article-title":"Bench to bedside: Electrophysiologic and clinical principles of noninvasive hemodynamic monitoring using impedance cardiography","volume":"10","author":"Summers","year":"2003","journal-title":"Acad. Emerg. Med."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1186\/s13613-018-0365-y","article-title":"Assessment of fluid responsiveness in spontaneously breathing patients: A systematic review of literature","volume":"8","author":"Chaves","year":"2018","journal-title":"Ann. Intensive Care."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"668","DOI":"10.1016\/j.jclinane.2012.06.003","article-title":"Comprehensive review: Is it better to use the Trendelenburg position or passive leg raising for the initial treatment of hypovolemia?","volume":"24","author":"Geerts","year":"2012","journal-title":"J. Clin. Anesth."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"190","DOI":"10.1097\/00005373-198203000-00003","article-title":"Passive leg raising does not produce a significant or sustained autotransfusion effect","volume":"22","author":"Gaffney","year":"1982","journal-title":"J. Trauma"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"e15537","DOI":"10.14814\/phy2.15537","article-title":"Observational study on passive leg raising and the autonomic nervous system","volume":"10","author":"Sondergaard","year":"2022","journal-title":"Physiol. Rep."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"979","DOI":"10.1097\/00003246-198910000-00002","article-title":"Changes in cardiac output after acute blood loss and position change in man","volume":"17","author":"Wong","year":"1989","journal-title":"Crit. Care Med."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"393","DOI":"10.1055\/s-0034-1389089","article-title":"Passive leg raising during pregnancy","volume":"32","author":"Marques","year":"2015","journal-title":"Am. J. Perinatol."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"1210","DOI":"10.1152\/ajpregu.00127.2002","article-title":"Heart rate control and mechanical cardiopulmonary coupling to assess central volume: A systems analysis","volume":"283","author":"Barbieri","year":"2002","journal-title":"Am. J. Physiol. Regul. Integr. Comp. Physiol."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"579","DOI":"10.1007\/s00540-022-03075-2","article-title":"Assessing fluid responsiveness during spontaneous breathing","volume":"36","author":"Suehiro","year":"2022","journal-title":"J. Anesth."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"168","DOI":"10.1186\/s13613-020-00786-1","article-title":"Measurement site of inferior vena cava diameter affects the accuracy with which fluid responsiveness can be predicted in spontaneously breathing patients: A post hoc analysis of two prospective cohorts","volume":"10","author":"Caplan","year":"2020","journal-title":"Ann. Intensive Care."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"e290","DOI":"10.1097\/CCM.0000000000002090","article-title":"Diagnostic Accuracy of the Inferior Vena Cava Collapsibility to Predict Fluid Responsiveness in Spontaneously Breathing Patients with Sepsis and Acute Circulatory Failure","volume":"45","author":"Preau","year":"2017","journal-title":"Crit. Care Med."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"717","DOI":"10.1111\/anae.12678","article-title":"Pulse pressure variation to predict fluid responsiveness in spontaneously breathing patients: Tidal vs. forced inspiratory breathing","volume":"69","author":"Hong","year":"2014","journal-title":"Anaesthesia"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"648","DOI":"10.1111\/aas.13541","article-title":"Impact of deep breathing on predictability of stroke volume variation in spontaneous breathing patients","volume":"64","author":"Mukai","year":"2020","journal-title":"Acta Anaesthesiol. Scand."},{"key":"ref_44","doi-asserted-by":"crossref","unstructured":"Bronzwaer, A.G.T., Ouweneel, D.M., Stok, W.J., Westerhof, B.E., and van Lieshout, J.J. (2015). Arterial Pressure Variation as a Biomarker of Preload Dependency in Spontaneously Breathing Subjects\u2014A Proof of Principle. PLoS ONE, 10.","DOI":"10.1371\/journal.pone.0137364"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1081\/CBI-100001178","article-title":"Repeated assessment of the endogenous 24-hour profile of blood pressure under constant routine","volume":"18","author":"Maislin","year":"2001","journal-title":"Chronobiol. Int."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"980","DOI":"10.1161\/CIRCRESAHA.110.233668","article-title":"Existence of an endogenous circadian blood pressure rhythm in humans that peaks in the evening","volume":"108","author":"Shea","year":"2011","journal-title":"Circ. Res."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"1203","DOI":"10.1161\/ATVBAHA.119.312682","article-title":"Circadian Rhythm of Vascular Function in Midlife Adults","volume":"39","author":"Thosar","year":"2019","journal-title":"Arterioscler. Thromb. Vasc. Biol."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1016\/j.smrv.2016.02.003","article-title":"Circadian mechanisms of 24-hour blood pressure regulation and patterning","volume":"33","author":"Smolensky","year":"2017","journal-title":"Sleep Med. Rev."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"1755","DOI":"10.4103\/0366-6999.185866","article-title":"Passive Leg Raising in Intensive Care Medicine","volume":"129","author":"He","year":"2016","journal-title":"Chin. Med. J."},{"key":"ref_50","doi-asserted-by":"crossref","unstructured":"Vartun, A., Flo, K., and Acharya, G. (2014). Effect of passive leg raising on systemic hemodynamics of pregnant women: A dynamic assessment of maternal cardiovascular function at 22\u201324 weeks of gestation. PLoS ONE, 9.","DOI":"10.1371\/journal.pone.0094629"},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"463","DOI":"10.1042\/cs0880463","article-title":"Relationship between plasma volume, carotid baroreceptor sensitivity and orthostatic tolerance","volume":"88","author":"Hainsworth","year":"1995","journal-title":"Clin. Sci."}],"container-title":["Life"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-1729\/13\/7\/1606\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T20:16:56Z","timestamp":1760127416000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-1729\/13\/7\/1606"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,7,21]]},"references-count":51,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2023,7]]}},"alternative-id":["life13071606"],"URL":"https:\/\/doi.org\/10.3390\/life13071606","relation":{},"ISSN":["2075-1729"],"issn-type":[{"type":"electronic","value":"2075-1729"}],"subject":[],"published":{"date-parts":[[2023,7,21]]}}}