Hemodynamics, fluids & transfusion
Reliability of pulse pressure and stroke volume variation in assessing fluid responsiveness in the operating room: a metanalysis and a metaregression
Authors' conclusion
The overall performance of PPV and SVV in operating room in predicting fluid responsiveness is moderate, ranging close to an AUC of 0.80 only some subgroups of surgical patients.
Study context
- Population
- Adult surgical patients in the operating room
- Participants
- 2,947 patients · 59 studies
- Comparison
- PPV vs SVV for predicting fluid responsiveness
- Outcome
- Pooled AUC of ROC curves for predicting fluid responsiveness
Methodological detailsmetaregression, random effects models, QUADAS-2 risk of bias
- Metaregression
- Random effects models
- QUADAS-2 risk of bias
Pooled result
As reported in the abstract
Prediction of fluid responsiveness
| Group | Pooled AUC | Mean threshold |
|---|---|---|
| PPV | 0.77 (0.73-0.80) | 10.8 (10.6-11.0) |
| SVV | 0.76 (0.72-0.80) | 12.1 (11.6-12.7) |
Pooled AUC
PPV0.77 (0.73-0.80)
SVV0.76 (0.72-0.80)
Mean threshold
PPV10.8 (10.6-11.0)
SVV12.1 (11.6-12.7)
Further pooled results
Grey zone
| Outcome | PPV | SVV |
|---|---|---|
| Subgroups (subgroup) | ||
| AUC range | 0.69 and 0.81 | 0.73 to 0.79 |
| Best threshold range | 6.9 to 11.5% | 9.9 to 10.8% |
- Grey zone: 19 studies (32.2%) reported the grey zone
Metaregression: factors affecting PPV performance
- High Vt and colloids positively impacted PPV performance, especially with closed chest and abdomen or prone position
Original publication
Reliability of pulse pressure and stroke volume variation in assessing fluid responsiveness in the operating room: a metanalysis and a metaregression. Crit Care. Published 8 November 2023. doi:10.
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