Hemodynamics, fluids & transfusion
Passive leg raising test induced changes in plethysmographic variability index to assess fluid responsiveness in critically ill mechanically ventilated patients with acute circulatory failure
Authors' conclusion
In sedated and mechanically ventilated ICU patients with acute circulatory failure, PLR-induced changes in PVI accurately predict fluid responsiveness with an acceptable gray zone.
Study context
- Population
- Sedated mechanically ventilated ICU patients with acute circulatory failure19 fluid responders
- Participants
- 29 participants
- Comparison
- Passive leg raising (PLR)-induced changes in plethysmographic variability index (PVI) to predict fluid responsiveness
- ΔPVIPLRn = 29
- Primary endpoint
- Prediction of fluid responsiveness (volume expansion-induced increase in CI >15%, 500 mL crystalloid) by ΔPVIPLR: AUROC and gray zone
Primary result
As reported in the abstract
Prediction of fluid responsiveness
| Group | AUROC | Sensitivity (cut-off PVI decrease ≤ −24.1%) | Specificity (cut-off PVI decrease ≤ −24.1%) | Gray zone |
|---|---|---|---|---|
| ΔPVIPLR | 0.89 (95%CI: 0.72-0.98, p < 0.001) | 95% (95%CI: 74-100%) | 80% (95%CI: 44-97%) | 13.8% of patients |
ΔPVIPLR
AUROC0.89 (95%CI: 0.72-0.98, p < 0.001)
Sensitivity (cut-off PVI decrease ≤ −24.1%)95% (95%CI: 74-100%)
Specificity (cut-off PVI decrease ≤ −24.1%)80% (95%CI: 44-97%)
Gray zone13.8% of patients
Further findings
Correlation of relative ΔPVIPLR with changes in CI
- Correlation with PLR-induced change in CI (r)
- −0.58, p < 0.001
- Correlation with volume expansion-induced change in CI (r)
- −0.65, p < 0.001
Original publication
Passive leg raising test induced changes in plethysmographic variability index to assess fluid responsiveness in critically ill mechanically ventilated patients with acute circulatory failure. J Crit Care. Published 17 October 2023. doi:10.
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