To evaluate the predictive value of variability of aortic peak velocity (?Vpeak_AO) combined with passive leg raising test (PLR) for volume responsiveness in patients with severe acute pancreatitis (SAP) complicated with shock.

A total of 134 patients with SAP complicated with shock who were admitted to Peking University People's Hospital from August 2017 to August 2020 were included. PLR and volume expansion test (VE) were performed in all the patients, and bedside ultrasound was used to detect the changes of hemodynamics and ultrasound indicators before and after PLR and VE. According to whether the change of stroke volume (SV) (?SV) ≥ 15% or not after fluid replacement, the patients were divided into either a response group or a non-response group. Pearson correlation method was used to analyze the correlation between ?SV-VE and ?Vpeak_AO-PLR in the patients. The ROC curve was used to analyze the predictive value of ?Vpeak_AO combined with PLR for volume responsiveness in patients with SAP complicated with shock.

Before PLR, SV and Vpeak_AO of the response group were significantly lower than those of the non-response group (P=0.000). After PLR and VE, SV and Vpeak_AO of the response group were significantly higher than those before PLR (P<0.05) and those of the non-response group (P=0.000). Pearson correlation analysis showed that ?Vpeak_AO-PLR was positively correlated with ?SV-VE in patients with SAP complicated with shock (r=0.769, P<0.05). The area under the ROC curve of ?Vpeak_AO-PLR in predicting volume responsiveness in the patients with SAP complicated with shock was 0.924 (95% CI: 0.879~0.969). When the cut-off value was 10.9%, the sensitivity was 86.3% and the specificity was 88.5%.

?Vpeak_AO combined with PLR has good predictive value for volume responsiveness in patients with SAP complicated with shock.