Haemodynamics, fluids & transfusion
Predicting Fluid Responsiveness in Mechanically Ventilated Adults: An Umbrella Review of Diagnostic Accuracy Meta-Analyses
Authors' conclusion
Among dynamic predictors of fluid responsiveness, TVC and EEOT appear to be the most accurate and robust indices.
Study context
- Population
- Mechanically ventilated adults7 meta-analyses
- Participants
- 10,300 participants · 123 studies
- Comparison
- Dynamic indices and maneuvers for predicting fluid responsiveness
- Outcome
- Pooled AUC for predicting fluid responsiveness, as reported by the included meta-analyses
Methodological detailsCorrected Covered Area overlap assessment, cumulative meta-analysis, meta-regression
- Corrected Covered Area overlap assessment
- Cumulative meta-analysis
- Meta-regression
Pooled result
As reported in the abstract
Pooled AUC
Tidal volume challenge (TVC)
0.96
AUC · 95% CI 0.94–0.97
End-expiratory occlusion test (EEOT)
0.95
AUC · 95% CI 0.92–0.96
Passive leg raising (PLR)
0.91
AUC · 95% CI 0.88–0.93
PPV
0.87-0.88
AUC
Stroke volume variation (SVV)
0.87-0.88
AUC
Pleth variability index (PVI)
0.82-0.83
AUC
ΔIVC
0.82-0.83
AUC
Further pooled results
Overlap across meta-analyses (global Corrected Covered Area (CCA))
- Global CCA ≈5.5% to 5.6%, borderline slight-to-moderate overlap
Subgroup and moderator analyses
- Tidal volume was the main effect modifier; TVC and EEOT remained comparatively robust
Original publication
Predicting Fluid Responsiveness in Mechanically Ventilated Adults: An Umbrella Review of Diagnostic Accuracy Meta-Analyses. Anesth Analg. Published 15 July 2026. doi:10.
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