Perioperative medicine & outcomes
Non-invasive goal-directed fluid therapy with the pleth variability index (PVI): a systematic review and meta-analysis
Authors' conclusion
PVI-guided fluid management allows for a more restrictive and individualized approach without compromising hemodynamic or metabolic stability.
Study context
- Population
- Patients undergoing non-cardiac surgery
- Participants
- 1,105 patients · 9 studies
- Comparison
- PVI-guided fluid therapy vs conventional fluid management
- Outcome
- Total intraoperative fluid volume and crystalloid administration
Methodological detailsrandom-effects models, subgroup and sensitivity analyses, Search of PubMed, Embase and Cochrane up to January 2024
- Random-effects models
- Subgroup and sensitivity analyses
- Search of PubMed, Embase and Cochrane up to January 2024
Pooled result
As reported in the abstract
MD (total fluid volume)
- 761.23 mL
95% CI - 1267.42 to - 255.03
PVI-guided
MD (crystalloid administration)
- 655.05 mL
95% CI - 1096.48 to - 213.62
PVI-guided
Further pooled results
Colloid use, urine output, norepinephrine requirement, arterial pressure, acid-base balance, length of stay (LOS)
- No significant differences
Fluid volumes, abdominal surgeries (subgroup)
- Subgroup analysis confirmed the reduction in fluid volumes
Original publication
Non-invasive goal-directed fluid therapy with the pleth variability index (PVI): a systematic review and meta-analysis. J Clin Monit Comput. Published 8 August 2025. doi:10.
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