Hemodynamics, fluids & transfusion
Context-specific clinical applicability of the end-expiratory occlusion test to predict fluid responsiveness in mechanically ventilated patients: A systematic review and meta-analysis
Authors' conclusion
The EEOT for predicting fluid responsiveness in critical care performs acceptably well overall and is a confirmative test. In the operating room and/or with specific technical settings, its performance and clinical utility are reduced
Study context
- Population
- Mechanically ventilated adults (prospective clinical studies)
- Participants
- 1,073 participants · 24 studies
- Comparison
- End-expiratory occlusion test (EEOT) to predict fluid responsiveness, intensive care unit (ICU) vs operating room
- ICUn = 588
- Operating roomn = 485
- Outcome
- Predictive performance of the EEOT for fluid responsiveness
Methodological detailsOverall quality of evidence very low (high heterogeneity, risk of bias); no publication bias detected
- Overall quality of evidence very low (high heterogeneity, risk of bias); no publication bias detected
Pooled result
As reported in the abstract
Pooled diagnostic accuracy of EEOT (22 studies, 1049 volume expansions)
Pooled sensitivity
0.87
95% CI 0.81 to 0.92
Pooled specificity
0.90
95% CI 0.85 to 0.94
Median [IQR 3.3 to 5.3] cardiac index threshold increase for a positive test
5.0
Further pooled results
| Outcome | ICU | Operating room |
|---|---|---|
| Likelihood ratios by setting (subgroup) | ||
| Positive likelihood ratio | 14 | 3.1 |
| Negative likelihood ratio | 0.12 | 0.21 |
Likelihood ratios by setting (subgroup)
- Performance notably lower in the operating room
Sources of heterogeneity
- Clinical context, monitoring method, ratio of monitoring averaging time to occlusion time, PEEP level and cardiac output marker were significant sources of heterogeneity
- Occlusion duration and tidal volume did not significantly affect performance
Original publication
Context-specific clinical applicability of the end-expiratory occlusion test to predict fluid responsiveness in mechanically ventilated patients: A systematic review and meta-analysis. Eur J Anaesthesiol. Published 21 April 2025. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →