Effect of passive leg raising manoeuvre on the change in cardiac output in cirrhotic and noncirrhotic patients using transthoracic echocardiography. A Prospective observational study

Optimal fluid management is essential for maintaining hemodynamic stability during anesthesia and surgery. Assessing fluid responsiveness helps guide fluid therapy and prevent both hypovolemia and fluid overload. In patients with liver cirrhosis, altered cardiovascular physiology makes prediction of fluid responsiveness challenging. This prospective observational study aims to evaluate the effect of a passive leg raising (PLR) manoeuvre on cardiac output in cirrhotic and non-cirrhotic patients, using transthoracic echocardiography (TTE). Adult patients aged 18 to 65 years will be enrolled and divided into cirrhotic and non-cirrhotic groups. Cardiac output will be measured before and after the PLR manoeuvre to assess preload responsiveness. The primary outcome will be the percentage change in cardiac output following PLR in both groups. The study seeks to determine whether cirrhosis alters the hemodynamic response to PLR. The results may provide useful information for optimizing perioperative fluid management in cirrhotic and non-cirrhotic patients.