---
title: Trendelenburg Maneuver Versus Passive Leg Raising Test for Fluid Responsiveness in High-Risk Surgical Patients
nct_id: NCT06423833
overall_status: COMPLETED
phase: NA
sponsor: Tanta University
study_type: INTERVENTIONAL
primary_condition: Trendelenburg Maneuver
countries: Egypt
canonical_url: "https://parkinsonspathways.com/agent/trials/NCT06423833.md"
clinicaltrials_gov: "https://clinicaltrials.gov/study/NCT06423833"
ct_last_update_post_date: 2025-05-08
last_seen_at: "2026-05-12T06:42:30.985Z"
source: ClinicalTrials.gov (mirrored, no enrichment)
---
# Trendelenburg Maneuver Versus Passive Leg Raising Test for Fluid Responsiveness in High-Risk Surgical Patients

**NCT ID:** [NCT06423833](https://clinicaltrials.gov/study/NCT06423833)

## Key Facts

- **Status:** COMPLETED
- **Phase:** NA
- **Study Type:** INTERVENTIONAL
- **Target Enrollment:** 60
- **Lead Sponsor:** Tanta University
- **Conditions:** Trendelenburg Maneuver, Passive Leg Raising, High-Risk Surgical Patients
- **Start Date:** 2023-02-01
- **Completion Date:** 2025-05-06
- **CT.gov Last Update:** 2025-05-08

## Brief Summary

The aim of this study is to evaluate whether Trendelenburg maneuver can be used to predict fluid responsiveness in high-risk surgical patients in intensive care unit as compared to Passive Leg Raising test.

## Detailed Description

Passive Leg Raising test is a well validated dynamic method to predict fluid responsiveness with many advantages as it doesn't use fluid loading, its effect is reversible, and it doesn't rely on heart-lung interaction. However, it has many limitations as (has false negative effect in patients with intra-abdominal hypertension), also, it may not be suitable in some surgical patients.

Trendelenburg maneuver (TM) is often used to treat hemodynamic unstable patients when hypovolemia is suspected, through a mechanism similar to Passive Leg Raising test Yonis, et al reports that change in cardiac output during Trendelenburg maneuver is a reliable predictor of fluid responsiveness in patients with acute respiratory distress syndrome in prone position under protective ventilation. Another study reports that change in velocity time integral during trendelenburg maneuver predicts fluid responsiveness in cardiac surgical patients in operating rooms

## Eligibility

- **Minimum age:** 18 Years
- **Sex:** ALL
- **Healthy Volunteers:** No

```
Inclusion Criteria:

* Aged ≥ 18 years old.
* Criteria of high-risk surgical patients:

  1. Elderly ≥ 70 years old undergoing major surgery.
  2. Physical status ≥ 3 or more undergoing major surgery.
  3. Major intraoperative hemorrhage with Surgical Apgar Score (SAS 0-4).
  4. Emergency of upper abdominal surgery.
* Criteria of hypoperfusion ≥ 2 or more the following:

  1. Mean arterial blood pressure \< 65 mmHg.
  2. Urine output \< 0.5 ml/Kg/hr.
  3. Capillary refilling time \> 4 seconds.
  4. Blood lactate \> 2 mmol/L.
  5. ScvO2 \< 70%.
  6. CO2 gap \> 6 mmHg.
* Provided that:SpO2 ≥ 90% and Hb ≥ 7 g/dl.

Exclusion Criteria:

* Patients with body mass index \> 35 kg/m2.
* Pregnant female.
* Contraindications to the Trendelenburg position or PLR test (major head trauma, intra-abdominal hypertension and gastric retention).
* Poor echo window or unsatisfactory cardiac echogenicity (an inability to correctly align the Doppler beam to generate reliable velocity time integral measurements at the left ventricular outflow tract \[LVOT\]).
```

## Arms

- **Trendelenburg maneuver** (EXPERIMENTAL) — The investigator will measure changes in velocity time integral (VTI) and stroke volume (SV) during Trendelenburg maneuver (TM) in high-risk surgical patients by trans-thoracic Doppler echo cardiography
- **Passive leg raising test** (ACTIVE_COMPARATOR) — The investigator will measure changes in velocity time integral (VTI) and stroke volume (SV) during passive leg raising (PLR) test in high-risk surgical patients by trans-thoracic Doppler echo cardiography

## Interventions

- **Trendelenburg maneuver (TM)** (DIAGNOSTIC_TEST) — The investigator will measure changes in velocity time integral (VTI) and stroke volume (SV) during Trendelenburg maneuver (TM) in high-risk surgical patients by trans-thoracic Doppler echo cardiography.
- **Passive leg raising test** (DIAGNOSTIC_TEST) — The investigator will measure changes in velocity time integral (VTI) and stroke volume (SV) during Passive leg raising (PLR) test in high-risk surgical patients by trans-thoracic Doppler echo cardiography.

## Primary Outcomes

- **The validity of Trendelenburg maneuver** _(time frame: At the end of Trendelenburg maneuver within 1 minute)_ — Measurement of the validity of Trendelenburg maneuver to predict fluid responsiveness by measuring the percentage change in velocity time integral (VTI) by Doppler echocardiography in high risk-surgical patients.

## Secondary Outcomes

- **Correlation between the accuracy of the percentage change in velocity time integral (VTI) during Trendelenburg maneuver and passive leg raising test (PLR) test** _(time frame: At the end of Trendelenburg maneuver and passive leg raising test within 1 minute)_

## Locations (1)

- Tanta University Hospitals, Tanta, El-Gharbia, Egypt

## Recent Field Changes (last 30 days)

- `status.overallStatus` — added _(2026-05-12)_
- `status.primaryCompletionDate` — added _(2026-05-12)_
- `status.completionDate` — added _(2026-05-12)_
- `status.lastUpdatePostDate` — added _(2026-05-12)_
- `design.phases` — added _(2026-05-12)_
- `design.enrollmentCount` — added _(2026-05-12)_
- `eligibility.criteria` — added _(2026-05-12)_
- `eligibility.minAge` — added _(2026-05-12)_
- `eligibility.sex` — added _(2026-05-12)_
- `outcomes.primary` — added _(2026-05-12)_
- `outcomes.secondary` — added _(2026-05-12)_
- `armsInterventions.arms` — added _(2026-05-12)_
- `armsInterventions.interventions` — added _(2026-05-12)_
- `sponsor.lead` — added _(2026-05-12)_
- `results.hasResults` — added _(2026-05-12)_
- `locations.tanta university hospitals|tanta|el-gharbia|egypt` — added _(2026-05-12)_

---

*Canonical: https://parkinsonspathways.com/agent/trials/NCT06423833.md*  
*Source data (authoritative): https://clinicaltrials.gov/study/NCT06423833*  
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