ArticleCritical care (London, England)2021
Do changes in pulse pressure variation and inferior vena cava distensibility during passive leg raising and tidal volume challenge detect preload responsiveness in case of low tidal volume ventilation?
Article in Critical care (London, England), 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05428423 (Assessment of the Reliability of Changes in Plethysmography Variability Index During Tidal Volume Challenge for Predicting Fluid Responsiveness in Intensive Care Unit Patients), which is not on this map. Cited by 25 papers, 4 of them syntheses that pooled it.
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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.
Assessment of the Reliability of Changes in Plethysmography Variability Index During Tidal Volume Challenge for Predicting Fluid Responsiveness in Intensive Care Unit Patients
Who cites it
25 citing papers in PubMed, 4 syntheses or guidelines pooled it.
- ESICM guidelines on circulatory shock and hemodynamic monitoring 2025.Intensive care medicine · 2025Guideline
- Changes in pulse pressure variation induced by passive leg raising test to predict preload responsiveness in mechanically ventilated patients with low tidal volume in ICU: a systematic review and meta-analysis.Critical care (London, England) · 2025Pooled it
- Does tidal volume challenge improve the feasibility of pulse pressure variation in patients mechanically ventilated at low tidal volumes? A systematic review and meta-analysis.Critical care (London, England) · 2023Pooled it
- Fluid challenge in critically ill patients receiving haemodynamic monitoring: a systematic review and comparison of two decades.Critical care (London, England) · 2022Pooled it
- Respiratory variation in the internal jugular vein does not predict fluid responsiveness in the prone position during adolescent idiopathic scoliosis surgery: a prospective cohort study.BMC anesthesiology · 2023Trial
- The increase in cardiac output induced by a decrease in positive end-expiratory pressure reliably detects volume responsiveness: the PEEP-test study.Critical care (London, England) · 2023Trial
- The predictive value of tidal volume challenge-induced hemodynamic changes for fluid responsiveness in patients undergoing thoracoscopic surgery with one-lung ventilation: a prospective observational study.BMC anesthesiology · 2026Observational
- Heart-lungs interactions in mechanically ventilated patients: physiology and clinical implications.Intensive care medicine · 2026Article
- Ultrasound of the inferior vena cava for fluid therapy decisions: Strengths, limitations, and an integrated approach.The Journal of international medical research · 2026Review
- Applied physiology at the bedside: using invasive blood pressure as a true monitoring tool.Annals of intensive care · 2025Review
- The role of the tidal volume challenge test in volume responsiveness assessment: a narrative review.Journal of anesthesia, analgesia and critical care · 2025Review
- 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
- Assessment of Fluid Responsiveness via Central Venous Ultrasound Measurement: A Network Meta-Analysis.Journal of clinical medicine · 2025Review
- Changes in central venous-to-arterial PCOCritical care (London, England) · 2024Article
- Testing preload responsiveness by the tidal volume challenge assessed by the photoplethysmographic perfusion index.Critical care (London, England) · 2024Article
- Heart-Lungs interactions: the basics and clinical implications.Annals of intensive care · 2024Review
- Recent advances in cardiorespiratory monitoring in acute respiratory distress syndrome patients.Journal of intensive care · 2024Review
- Supine transfer test-induced changes in cardiac index predict fluid responsiveness in patients without intra-abdominal hypertension.BMC anesthesiology · 2023Article
- How to integrate hemodynamic variables during resuscitation of septic shock?Journal of intensive medicine · 2023Review
- How I personalize fluid therapy in septic shock?Critical care (London, England) · 2023Review
Corrections and comments
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundIn patients ventilated with tidal volume (Vt) < 8 mL/kg, pulse pressure variation (PPV) and, likely, the variation of distensibility of the inferior vena cava diameter (IVCDV) are unable to detect preload responsiveness. In this condition, passive leg raising (PLR) could be used, but it requires a measurement of cardiac output. The tidal volume (Vt) challenge (PPV changes induced by a 1-min increase in Vt from 6 to 8 mL/kg) is another alternative, but it requires an arterial line. We tested whether, in case of Vt = 6 mL/kg, the effects of PLR could be assessed through changes in PPV (ΔPPV
methodsIn 30 critically ill patients without spontaneous breathing and cardiac arrhythmias, ventilated with Vt = 6 mL/kg, we measured cardiac index (CI) (PiCCO2), IVCDV and PPV before/during a PLR test and before/during a Vt challenge. A PLR-induced increase in CI ≥ 10% defined preload responsiveness.
resultsAt baseline, IVCDV was not different between preload responders (n = 15) and non-responders. Compared to non-responders, PPV and IVCDV decreased more during PLR (by - 38 ± 16% and - 26 ± 28%, respectively) and increased more during the Vt challenge (by 64 ± 42% and 91 ± 72%, respectively) in responders. ∆PPV
conclusionsDuring mechanical ventilation with Vt = 6 mL/kg, the effects of PLR can be assessed by changes in PPV. If IVCDV is used, it should be expressed in percent and not absolute changes. The effects of the Vt challenge can be assessed on PPV, but not on IVCDV, since the diagnostic threshold is too small compared to the reproducibility of this variable.
trial registrationAgence Nationale de Sécurité du Médicament et des Produits de santé: ID-RCB: 2016-A00893-48.
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