Cardiothoracic & vascular anesthesia
Predictive Ability of Stroke Volume Changes Following Positive End-Expiratory Pressure Reduction on Fluid Responsiveness During One-Lung Ventilation
Authors' conclusion
During OLV, the relative increase in SV elicited by the PEEP test predicted fluid responsiveness as defined by the Trendelenburg maneuver.
Study context
- Population
- Adults undergoing elective lung resection requiring one-lung ventilation (OLV), closed-chest conditions38 analysed
- Participants
- 43 adults
- Comparison
- ΔSVPEEP test vs ΔMAPPEEP test vs stroke volume variation (SVV)
- Outcome
- Diagnostic accuracy of the ΔSVPEEP test for predicting fluid responsiveness (≥10% stroke volume (SV) increase after 15° head-down tilt)
Methodological detailssingle-centre, prospective interventional
- Single-centre
- Prospective interventional
Performance
As reported in the abstract
Prediction of fluid responsiveness
| Test or model | AUC | Optimal cutoff | Sensitivity | Specificity |
|---|---|---|---|---|
| ΔSVPEEP test | 0.95 (95% CI, 0.82-0.99; P < .0001) | 8.6% | 94.4% (95% CI, 72.7-99.9) | 80.0% (95% CI, 56.3-94.3) |
ΔSVPEEP test
AUC0.95 (95% CI, 0.82-0.99; P < .0001)
Optimal cutoff8.6%
Sensitivity94.4% (95% CI, 72.7-99.9)
Specificity80.0% (95% CI, 56.3-94.3)
Secondary outcomes
| Outcome | ΔMAPPEEP test | SVV | P value |
|---|---|---|---|
| ΔSVPEEP test, responders vs nonresponders | P < 0.0001 | ||
| Prediction of fluid responsiveness by ΔMAPPEEP test and SVV | |||
| AUC | 0.84 (95% CI, 0.68-0.94; P < .0001) | 0.64 (95% CI, 0.47-0.79; P = .12) |
- Gray zone for ΔSVPEEP test
- 36.8% · 14 events
- ΔSVPEEP test, responders vs nonresponders: Responders 16.7% ± 8.9
- ΔSVPEEP test, responders vs nonresponders: Nonresponders 4.6% ± 4.3
- Gray zone for ΔSVPEEP test: 14 of 38 patients within gray zone
Prediction of fluid responsiveness by ΔMAPPEEP test and SVV
- SVV not predictive
Original publication
Predictive Ability of Stroke Volume Changes Following Positive End-Expiratory Pressure Reduction on Fluid Responsiveness During One-Lung Ventilation. Anesth Analg. Published 10 June 2026. doi:10.
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