ArticleCritical care (London, England)2018
End-expiratory occlusion maneuver to predict fluid responsiveness in the intensive care unit: an echocardiographic study.
Article in Critical care (London, England), 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 33 papers, 4 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Dynamic Parameters in Evaluation of Fluid Resposiveness in Cardiac Surgery Patients in the Early Postoperative Period
"Mini Fluid Challenge Assessment: a Comparison Among Three Hemodynamic Tools"
Who cites it
33 citing papers in PubMed, 4 syntheses or guidelines pooled it.
- Context-specific clinical applicability of the end-expiratory occlusion test to predict fluid responsiveness in mechanically ventilated patients: A systematic review and meta-analysis.European journal of anaesthesiology · 2025Pooled it
- Assessment of fluid responsiveness using pulse pressure variation, stroke volume variation, plethysmographic variability index, central venous pressure, and inferior vena cava variation in patients undergoing mechanical ventilation: a systematic review and meta-analysis.Critical care (London, England) · 2024Pooled it
- Fluid challenge in critically ill patients receiving haemodynamic monitoring: a systematic review and comparison of two decades.Critical care (London, England) · 2022Pooled it
- Functional hemodynamic tests: a systematic review and a metanalysis on the reliability of the end-expiratory occlusion test and of the mini-fluid challenge in predicting fluid responsiveness.Critical care (London, England) · 2019Pooled it
- Can carotid artery Doppler variations induced by the end-expiratory occlusion maneuver predict fluid responsiveness in septic shock patients?Critical care (London, England) · 2023Trial
- A Comprehensive Review of Fluid Resuscitation Strategies in Traumatic Brain Injury.Journal of clinical medicine · 2025Review
- Real-time changes in pulse pressure during a 10-second end-expiratory occlusion test reliably detect preload responsiveness.Critical care (London, England) · 2025Article
- Assessing fluid responsiveness by using functional hemodynamic tests in critically ill patients: a narrative review and a profile-based clinical guide.Journal of clinical monitoring and computing · 2025Review
- Feasibility of Fluid Responsiveness Assessment in Patients at Risk for Increased Intracranial Pressure.Journal of clinical medicine · 2024Article
- Fluid Management in Veno-Arterial Extracorporeal Membrane Oxygenation Therapy-Analysis of an Experimental Pig Model.Journal of clinical medicine · 2023Article
- Prediction of Fluid Responsiveness Using Combined End-Expiratory and End-Inspiratory Occlusion Tests in Cardiac Surgical Patients.Journal of clinical medicine · 2023Article
- Novel Methods for Predicting Fluid Responsiveness in Critically Ill Patients-A Narrative Review.Diagnostics (Basel, Switzerland) · 2022Review
- Prediction of Fluid Responsiveness by the Effect of the Lung Recruitment Maneuver on the Perfusion Index in Mechanically Ventilated Patients During Surgery.Frontiers in medicine · 2022Article
- Methods of assessing fluid responsiveness in septic shock patients: a narrative review.Anaesthesiology intensive therapy · 2022Review
- Changes in peripheral perfusion index during intraoperative end-expiratory occlusion tests do not predict the response to fluid administration in patients undergoing lung protective ventilation.Journal of anesthesia · 2021Article
- Bioreactance reliably detects preload responsiveness by the end-expiratory occlusion test when averaging and refresh times are shortened.Annals of intensive care · 2021Article
- Predictors of fluid responsiveness in critically ill patients mechanically ventilated at low tidal volumes: systematic review and meta-analysis.Annals of intensive care · 2021Review
- Trendelenburg maneuver predicts fluid responsiveness in patients on veno-arterial extracorporeal membrane oxygenation.Annals of intensive care · 2021Article
- Do changes in perfusion index reflect changes in stroke volume during preload-modifying manoeuvres?Journal of clinical monitoring and computing · 2020Article
- The end-expiratory occlusion test for detecting preload responsiveness: a systematic review and meta-analysis.Annals of intensive care · 2020Article
Corrections and comments
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundIn mechanically ventilated patients, an increase in cardiac index during an end-expiratory-occlusion test predicts fluid responsiveness. To identify this rapid increase in cardiac index, continuous and instantaneous cardiac index monitoring is necessary, decreasing its feasibility at the bedside. Our study was designed to investigate whether changes in velocity time integral and in peak velocity obtained using transthoracic echocardiography during an end-expiratory-occlusion maneuver could predict fluid responsiveness.
methodsThis single-center, prospective study included 50 mechanically ventilated critically ill patients. Velocity time integral and peak velocity were assessed using transthoracic echocardiography before and at the end of a 12-sec end-expiratory-occlusion maneuver. A third set of measurements was performed after volume expansion (500 mL of saline 0.9% given over 15 minutes). Patients were considered as responders if cardiac output increased by 15% or more after volume expansion.
resultsTwenty-eight patients were responders. At baseline, heart rate, mean arterial pressure, cardiac output, velocity time integral and peak velocity were similar between responders and non-responders. End-expiratory-occlusion maneuver induced a significant increase in velocity time integral both in responders and non-responders, and a significant increase in peak velocity only in responders. A 9% increase in velocity time integral induced by the end-expiratory-occlusion maneuver predicted fluid responsiveness with sensitivity of 89% (95% CI 72% to 98%) and specificity of 95% (95% CI 77% to 100%). An 8.5% increase in peak velocity induced by the end-expiratory-occlusion maneuver predicted fluid responsiveness with sensitivity of 64% (95% CI 44% to 81%) and specificity of 77% (95% CI 55% to 92%). The area under the receiver operating curve generated for changes in velocity time integral was significantly higher than the one generated for changes in peak velocity (0.96 ± 0.03 versus 0.70 ± 0.07, respectively, P = 0.0004 for both). The gray zone ranged between 6 and 10% (20% of the patients) for changes in velocity time integral and between 1 and 13% (62% of the patients) for changes in peak velocity.
conclusionsIn mechanically ventilated and sedated patients in the neuro Intensive Care Unit, changes in velocity time integral during a 12-sec end-expiratory-occlusion maneuver were able to predict fluid responsiveness and perform better than changes in peak velocity.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.