Hemodynamics, fluids & transfusion
SIGH35 and end-expiratory occlusion test for assessing fluid responsiveness in critically ill patients undergoing pressure support ventilation
Authors' conclusion
In a selected ICU population undergoing PSV, SGH35 reliably predicted fluid responsiveness and performed better than the EEOT, which is, however, still reliable in the subgroup of ICU patients having a small extent of inspiratory efforts.
Study context
- Population
- Intensive care unit (ICU) patients on pressure support ventilation with different inspiratory effort requiring volume expansion56 analysed
- Participants
- 60 patients
- Comparison
- SIGH35 vs end-expiratory occlusion test (EEOT) for predicting fluid responsiveness
- Outcome
- Discrimination of fluid responsiveness (CO increase ≥ 10% after 4 ml/kg crystalloids over 10 min), AUC of ROC curves compared
Methodological detailssingle ICU, General ICU; hemodynamics recorded with MOSTCARE® system
- Single ICU
- General ICU; hemodynamics recorded with MOSTCARE® system
Performance
As reported in the abstract
Prediction of fluid responsiveness
| Test or model | AUC | Sensitivity | Specificity | Best threshold | Grey zone |
|---|---|---|---|---|---|
| SIGH35 | 0.93 (0.84-0.99) | 93.1% (78.0-98.7%) | 91.6 (73.0-98.9%) | - 25% pulse pressure (PP) from baseline | - 15%/35% |
| EEOT | 0.67 (0.52-0.81) | 72.4% (54.3-85.3%) | 70.3% (73.0-98.9%) | 4% of cardiac output (CO) increase from baseline | - 1%/10% |
AUC
SIGH350.93 (0.84-0.99)
EEOT0.67 (0.52-0.81)
Sensitivity
SIGH3593.1% (78.0-98.7%)
EEOT72.4% (54.3-85.3%)
Specificity
SIGH3591.6 (73.0-98.9%)
EEOT70.3% (73.0-98.9%)
Best threshold
SIGH35- 25% PP from baseline
EEOT4% of CO increase from baseline
Grey zone
SIGH35- 15%/35%
EEOT- 1%/10%
Further findings
| Outcome | SIGH35 | EEOT | P value |
|---|---|---|---|
| Prediction of fluid responsiveness, P0.1 < 1.5 cmH2O (subgroup)Comparable | P = 0.26 | ||
| AUC | 0.98 (0.94-0.99) | 0.89 (0.72-0.99 |
Original publication
SIGH35 and end-expiratory occlusion test for assessing fluid responsiveness in critically ill patients undergoing pressure support ventilation. Crit Care. Published 2 May 2025. doi:10.
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