ArticleIndian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine2021
Comparison of Changes in PPV Using a Tidal Volume Challenge with a Passive Leg Raising Test to Predict Fluid Responsiveness in Patients Ventilated Using Low Tidal Volume.
Article in Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 3 of them syntheses that pooled it.
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8 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- 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
- Effect of different targets of goal-directed fluid therapy on intraoperative hypotension and fluid infusion in robot-assisted laparoscopic gynecological surgery: a randomized non-inferiority trial.Journal of robotic surgery · 2024Trial
- Changes in internal jugular vein respiratory variation during tidal volume challenge predict volume responsiveness in lumbar surgery under protective ventilation: a prospective cohort study.Journal of intensive care · 2025Article
- The role of the tidal volume challenge test in volume responsiveness assessment: a narrative review.Journal of anesthesia, analgesia and critical care · 2025Review
- Tidal Volume Challenge to Assess Volume Responsiveness with Dynamic Preload Indices During Non-Cardiac Surgery: A Prospective Study.Journal of clinical medicine · 2024Article
- Prediction of fluid responsiveness. What's new?Annals of intensive care · 2022Review
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5 authors.
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Abstract
backgroundTidal volume challenge pulse pressure variation (TVC-PPV) is considered one of the recent reliable dynamic indices of fluid responsiveness (FR); also, passive leg raising (PLR)-induced changes in cardiac output (CO) detected by echocardiography are considered a reliable reversible self-fluid challenge test; many patients share eligibility for both tests.
objectivesThe study aimed to compare the sensitivity and specificity of both tests for the prediction of FR in mechanically ventilated patients with hemodynamic instability.
methodsWe studied 46 patients. Hemodynamic parameters including PPV and CO (detected by velocity time integral (VTI) using echocardiography) recorded at tidal volume (VT) of 6 mL/kg/ideal body weight (IBW) in semi-recumbent position then recorded again after one-minute increase in TV from 6 to 8 mL/kg/IBW then recorded with PLR at TV of 6 mL/kg/IBW and finally with actual volume expansion in semi-recumbent position by 4 ml/kg bolus of crystalloid solution to define actual responders with increase of cardiac output of 15% or more.
resultsSixteen patients were responders, and thirty patients were nonresponders; responders had significant increase in PPV with TVC 6 to 8 ml/kg/IBW with best cutoff value of 3.5 with a sensitivity of 93.8% and a specificity of 93.9%. PLR test-induced changes in CO had a sensitivity of 93.9% and a specificity of 86.7% with statistically best cutoff value of 6.5% increase in CO, but sensitivity was 75% at cutoff value of 10% increase in CO. Other parameters like PPV, PPV changes with PLR test, and PPV changes with fluid expansion were less sensitive indicators.
conclusionFR in patients with hemodynamic instability and mechanically ventilated with low tidal volume strategy can be efficiently predicted when PPV increases more than 3.5 with tidal volume challenge and when PLR induces 6.5% increase in CO monitored through VTI method by Doppler echocardiography, and both tests are equally reliable. HOW TO CITE THIS ARTICLE: Elsayed AI, Selim KAW, Zaghla HE, Mowafy HE, Fakher MA. Comparison of Changes in PPV Using a Tidal Volume Challenge with a Passive Leg Raising Test to Predict Fluid Responsiveness in Patients Ventilated Using Low Tidal Volume. Indian J Crit Care Med 2021;25(6):685-690.
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