Pulse pressure variation accurately predicts fluid responsiveness with a sensitivity of 88% and specificity of 89%, provided its physiological limitations are respected.
Does pulse pressure variation accurately predict fluid responsiveness?
Pulse pressure variation is an accurate predictor of fluid responsiveness when its physiological limitations are understood and respected.
Effect estimate: sensitivity 88%, specificity 89%
Since its first description in 1999 1, many studies have demonstrated the value of pulse pressure variation (PPV) as a predictor of fluid responsiveness. These studies were pooled together in a recent meta-analysis 2 concluding that PPV predicts fluid responsiveness accurately (sensitivity 88%, specificity 89%), so long as limitations to its use 3,4 are understood and respected (Figure 1). Figure 1 Most common physiological limitations to the use of pulse pressure variation can be summarized as ‘LIMITS’. HR/RR, heart rate/respiratory rate.
Michard et al. (Tue,) conducted a editorial in Fluid responsiveness. Pulse pressure variation (PPV) was evaluated on Fluid responsiveness (sensitivity 88%, specificity 89%). Pulse pressure variation accurately predicts fluid responsiveness with a sensitivity of 88% and specificity of 89%, provided its physiological limitations are respected.