August 31, 2024Critical Care41 citationsOpen Access

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

RCRenato Carneiro de Freitas ChavesHospital Israelita Albert Einstein CBCarmen Sílvia Valente BarbasHospital Israelita Albert Einstein VQVerônica Neves Fialho QueirozHospital Israelita Albert Einstein

Structured PICO

Do PPV, SVV, and PVI better predict fluid responsiveness compared to CVP and ∆IVC in adult patients undergoing mechanical ventilation?

Population

Adult patients undergoing mechanical ventilation

Intervention

Pulse pressure variation (PPV), stroke volume variation (SVV), and plethysmographic variability index (PVI)

Comparator

Central venous pressure (CVP) and inferior vena cava variation (∆IVC)

Outcome

Prediction of fluid responsivenesssurrogate

Dynamic indices like PPV, SVV, and PVI are superior to static indices like CVP and ∆IVC for predicting fluid responsiveness in mechanically ventilated adults.

Abstract

Fluid 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.

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