Haemodynamics, fluids & transfusion
Variation of perfusion index to evaluate fluid responsiveness during the preload challenge tests: a systematic review and meta-analysis
Authors' conclusion
Our meta-analysis suggests that ΔPI may serve as a promising adjunct non-invasive marker for predicting fluid responsiveness during preload challenge tests, but the current evidence base remains limited, heterogeneous, and at risk of bias.
Study context
- Population
- Adults undergoing preload challenge tests492 preload challenge tests
- Participants
- 419 adults · 9 studies
- Outcome
- Diagnostic accuracy of ΔPI for predicting fluid responsiveness (pooled sensitivity, specificity, DOR, AUROC)
Methodological detailssubgroup analysis, Deeks' funnel plot asymmetry test
- Subgroup analysis
- Deeks' funnel plot asymmetry test
Pooled result
As reported in the abstract
Prediction of fluid responsiveness
| Group | Sensitivity | Specificity | Diagnostic odds ratio (DOR) | AUC |
|---|---|---|---|---|
| ΔPI | 0.79 (95% CI: 0.71-0.85) | 0.82 (95% CI: 0.75-0.87) | 17 (95% CI: 10-30) | 0.88 (95% CI: 0.85-0.90) |
ΔPI
Sensitivity0.79 (95% CI: 0.71-0.85)
Specificity0.82 (95% CI: 0.75-0.87)
Diagnostic odds ratio (DOR)17 (95% CI: 10-30)
AUC0.88 (95% CI: 0.85-0.90)
- Fluid responsive
- 52%
Further pooled results
Subgroups (setting, preload challenge type, perfusion index (PI) device, ventilation status)
- ΔPI performed consistently across ICU and OR settings, regardless of preload challenge type, PI device, or ventilation status
Original publication
Variation of perfusion index to evaluate fluid responsiveness during the preload challenge tests: a systematic review and meta-analysis. Ann Intensive Care. Published 21 August 2026. doi:10.
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