Respiratory failure & ventilation
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
Authors' conclusion
PLR-induced change in absolute PPV has good diagnostic performance in predicting preload/fluid responsiveness in ICU patients on mechanical ventilation with low tidal volume.
Study context
- Population
- Mechanically ventilated ICU patients with low tidal volume
- Participants
- 474 participants · 5 studies
- Outcome
- Prediction of preload/fluid responsiveness by PLR-induced change in PPV (pooled sensitivity, specificity, SROC)
Methodological detailsQUADAS-2 risk of bias, Deeks' funnel plot asymmetry test
- QUADAS-2 risk of bias
- Deeks' funnel plot asymmetry test
Pooled result
As reported in the abstract
Preload/fluid responsiveness
| Group | AUC (SROC) | Pooled sensitivity | Pooled specificity | Diagnostic OR |
|---|---|---|---|---|
| Passive leg raising (PLR)-induced PPV change | 0.91 (95% CI 0.88-0.93) | 0.88 (95% CI 0.82-0.91) | 0.83 (95% CI 0.76-0.89) | 35 (95% CI 19-67) |
Passive leg raising (PLR)-induced PPV change
AUC (SROC)0.91 (95% CI 0.88-0.93)
Pooled sensitivity0.88 (95% CI 0.82-0.91)
Pooled specificity0.83 (95% CI 0.76-0.89)
Diagnostic OR35 (95% CI 19-67)
Further pooled results
Cutoff values of PLR-induced absolute PPV change
- Mean and median cutoff
- −2 points
- Range of cutoffs
- −2.5 to −1 points
Post-test probability (Fagan's nomogram, pre-test probability 50%)
- Positive test
- 84%
- Negative test
- 17%
Original publication
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. Crit Care. Published 9 January 2025. doi:10.
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