Who first published the passive leg raise (PLR) test?

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Who First Published the Passive Leg Raise Test

The provided evidence does not identify the original discoverer or first publication of the passive leg raise (PLR) test. The earliest research study included in this evidence base dates to 2006, when Monnet et al. published a prospective study in Critical Care Medicine demonstrating that PLR-induced changes in aortic blood flow could predict fluid responsiveness in mechanically ventilated patients 1. However, this 2006 publication clearly describes PLR as an established technique being investigated for a specific application, not as a novel discovery.

Historical Context from Available Evidence

The 2006 Critical Care Medicine study by Monnet et al. represents the earliest detailed investigation of PLR for predicting fluid responsiveness in the provided literature, but explicitly refers to PLR as a pre-existing "self-volume challenge" rather than introducing it as a new concept 1.

Key Points About PLR's Clinical Evolution

  • By 2015, the International Consensus on First Aid Science was already reviewing multiple observational studies from earlier years examining PLR at various angles (60°, 45°) and durations (20 seconds to 7 minutes) in normotensive subjects, indicating the test had been under investigation for some time 2.

  • The 2016 systematic review and meta-analysis in Critical Care Medicine analyzed 23 clinical trials totaling 1,013 patients, demonstrating that by this time PLR had become a well-established technique with extensive validation across multiple clinical settings 3.

  • Current guidelines from 2019-2026 reference PLR as a standard bedside assessment tool with well-defined diagnostic thresholds and performance characteristics, but none cite the original discoverer 2, 4, 5.

What the Evidence Does Establish

The physiological mechanism of PLR—mobilizing approximately 300 mL of blood from the lower extremities and splanchnic circulation to create a reversible preload challenge—has been consistently described across multiple sources, but without attribution to an original investigator 4, 5, 6.

Diagnostic Performance Established by 2016

  • The meta-analysis demonstrated pooled sensitivity of 86% (95% CI, 79-92%) and specificity of 92% (95% CI, 88-96%) for predicting fluid responsiveness 3.

  • A positive likelihood ratio of 11 (95% CI, 7.6-17) was established across 2,260 patients in the British Journal of Anaesthesia meta-analysis 2.

To identify the original discoverer or first publication of the passive leg raise test, you would need to search medical literature predating 2006, likely in the fields of cardiovascular physiology, shock resuscitation, or critical care medicine from the 1970s-1990s, as the technique was already well-established by the time of the earliest studies provided in this evidence base.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Guideline

Fluid Resuscitation Based on Patient Weight

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2026

Guideline

Passive Leg Raise in Sepsis Management

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2025

Research

Bedside assessment of passive leg raising effects on venous return.

Journal of clinical monitoring and computing, 2011

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Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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