SynthesisCritical care (London, England)2024
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.
Synthesis in Critical care (London, England), 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 46 papers, 6 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
46 citing papers in PubMed, 6 syntheses or guidelines pooled it.
- European Resuscitation Council and European Society of Intensive Care Medicine guidelines 2025: post-resuscitation care.Intensive care medicine · 2025Guideline
- ESICM guidelines on circulatory shock and hemodynamic monitoring 2025.Intensive care medicine · 2025Guideline
- Non-invasive goal-directed fluid therapy with the pleth variability index (PVI): a systematic review and meta-analysis.Journal of clinical monitoring and computing · 2025Pooled 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
- 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
- Pooled it
- Non-Linear Threshold Effect of Dynamic Estimated Plasma Volume Status on Revealing In-Hospital Mortality Risk in Sepsis.The Kaohsiung journal of medical sciences · 2026Article
- Mini fluid challenge versus passive leg raising test for predicting fluid responsiveness in spontaneously breathing children.Pediatric research · 2026Article
- Respiratory variation in carotid artery blood flow peak velocity combined with tidal volume challenge in predicting fluid responsiveness of lung-protective ventilation patients: a feasibility study.Journal of clinical monitoring and computing · 2026Article
- Prophylactic infusion of norepinephrine enhances hemodynamic stability during propofol induction and early intubation period in elderly patients: a double-blind randomized placebo-controlled trial.Anesthesia and pain medicine · 2026Article
- Bedside Ultrasound and Noninvasive Cardiac Output Monitoring in Children with Septic Shock: A Retrospective Comparative Study.Pediatric cardiology · 2026Article
- Pre-anesthesia PVI for post-induction hypotension: a robust predictor or a random signal? Comments on Ollaek et al.Journal of anesthesia · 2026Article
- Pulse Index Continuous Cardiac Output-Guided Hemodynamic Therapy in Living Donor Kidney Transplantation: A Prospective Cohort Study.Journal of clinical medicine research · 2026Article
- Dynamic indices of fluid responsiveness: physiological basis and clinical limits.Intensive care medicine · 2026Article
- The relationship between central venous pressure and inferior vena cava diameter and distensibility in neonates under mechanical ventilation.Pediatric research · 2026Article
- Central Venous Pressure Revisited: Physiology, Pitfalls, Misconceptions, and Modern Clinical Interpretation in Critical Care.Journal of clinical medicine · 2026Review
- Rethinking ejection fraction for anesthesiologists: a narrative review.Perioperative medicine (London, England) · 2026Review
- The value of pleth variability index in predicting hypotension during maintenance hemodialysis: a prospective observational multicenter study (PVi-HD study).BMC nephrology · 2026Observational
- Comparison of the change in carotid corrected flow time and stroke volume variation for assessing volume responsiveness in general anesthesia patients: a prospective, observational study.Journal of clinical monitoring and computing · 2026Observational
- Treatment Response Phenotyping Informed by Patient Physiologic Characteristics Could Drive Precision Critical Care Through Augmented Intelligence: A Narrative Review.CHEST critical care · 2026Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
12 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
importanceManeuvers assessing fluid responsiveness before an intravascular volume expansion may limit useless fluid administration, which in turn may improve outcomes.
objectiveTo describe maneuvers for assessing fluid responsiveness in mechanically ventilated patients. REGISTRATION: The protocol was registered at PROSPERO: CRD42019146781. INFORMATION SOURCES AND SEARCH: PubMed, EMBASE, CINAHL, SCOPUS, and Web of Science were search from inception to 08/08/2023. STUDY SELECTION AND DATA COLLECTION: Prospective and intervention studies were selected. STATISTICAL ANALYSIS: Data for each maneuver were reported individually and data from the five most employed maneuvers were aggregated. A traditional and a Bayesian meta-analysis approach were performed.
resultsA total of 69 studies, encompassing 3185 fluid challenges and 2711 patients were analyzed. The prevalence of fluid responsiveness was 49.9%. Pulse pressure variation (PPV) was studied in 40 studies, mean threshold with 95% confidence intervals (95% CI) = 11.5 (10.5-12.4)%, and area under the receiver operating characteristics curve (AUC) with 95% CI was 0.87 (0.84-0.90). Stroke volume variation (SVV) was studied in 24 studies, mean threshold with 95% CI = 12.1 (10.9-13.3)%, and AUC with 95% CI was 0.87 (0.84-0.91). The plethysmographic variability index (PVI) was studied in 17 studies, mean threshold = 13.8 (12.3-15.3)%, and AUC was 0.88 (0.82-0.94). Central venous pressure (CVP) was studied in 12 studies, mean threshold with 95% CI = 9.0 (7.7-10.1) mmHg, and AUC with 95% CI was 0.77 (0.69-0.87). Inferior vena cava variation (∆IVC) was studied in 8 studies, mean threshold = 15.4 (13.3-17.6)%, and AUC with 95% CI was 0.83 (0.78-0.89).
conclusionsFluid responsiveness can be reliably assessed in adult patients under mechanical ventilation. Among the five maneuvers compared in predicting fluid responsiveness, PPV, SVV, and PVI were superior to CVP and ∆IVC. However, there is no data supporting any of the above mentioned as being the best maneuver. Additionally, other well-established tests, such as the passive leg raising test, end-expiratory occlusion test, and tidal volume challenge, are also reliable.
Indexed as
Identifiers
What OpenQuestion holds
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.