Evaluation of Fluid Responsiveness: Is Photoplethysmography a Noninvasive Alternative?

Table 1

Papers in which ΔPOP and/or PVI have been evaluated and fluid challenges performed.

Author, Ref.	Fluid challenge	CO/CI/SVI measurement	Responder	ROC	Threshold value	Sens/spec
Solus-Biguenet et al. [21]	250 mL colloid	Thermodilution	SVI: 10%	0.81	PPVfina: 14%	No data
				0.68	ΔPOP: 9.5%	No data
				0.79	PPVart: 12.5%	No data
Natalini et al. [22]	500 mL HES 6%	Thermodilution	CI: 15%	0.72	ΔPOP: 15%	56/86 (PPV/NPV)
				0.74	ΔPP: 15%	55/100 (PPV/NPV)
Cannesson et al. [23]	500 mL HES 6%	Thermodilution	CI: 15%	0.847	ΔPOP: 13%	93/90
				0.847	ΔPP: 11%	80/90
Feissel et al. [24]	8 mL/kg HES 6%	Echo-Doppler	CI: 15%	0.94	ΔPP: 12%	100/70
				0.94	ΔPOP: 14%	94/80
Wyffels et al. [25]	500 mL HES 6%	Intermittent thermodilution	CO: 15%	0.94	PPV: 11.3%	95/91.7
		by pulm. artery catheter		0.89	ΔPOP: 11.3%	90/83.3
Cannesson et al. [26]	500 mL HES 6%	Thermodilution	CI: 15%	0.94	ΔPP: 12.5%	87/89
				0.94	ΔPOP: 12%	87/89
				0.93	PVI: 14%	81/100
Westphal et al. [27]	500–1000 mL NaCl	Not measured	ΔPP > 13%	0.95	ΔPOP: 11%	91/100
Zimmermann et al. [28]	7 mL/kg HES 6%	FloTrac	SVI: 15%	0.97	PVI: 9.5 %	93/100
Loupec et al. [29]	500 mL HES	Echocardiography	CO: 15%	0.88	PVI: 17%	95/91
	or PLR if ΔPP < 13%
Desgranges et al. [30]	500 mL HES	Thermodilution	CI: 15%	0.91	PVIforehead : 15%	89/78
				0.88	PVIear: 16%	74/74
				0.84	PVIfinger : 12%	74/67
				0.84	PPV > 11%	74/89
					PVIforehead : 15%	89/100
					and PIforehead : 1.37
Renner et al. [31]	HES 10 mL kg^−1	Transoesophageal echocardiography	SVI: 15%	0.79	PVI > 13%	84/64
De Souza Neto et al. [32]	Saline, 20 mL/kg	Transthoracic echography	AVTI: 15%	0.51	0–6 yr: ΔPOP	No data
		(aortic velocity-time integral)		0.63	0–6 yr: PVI	No data
				0.71	0–6 yr: ΔPP	No data
				0.52	0–6 yr: PPV	No data
				0.57	6–14 yr: ΔPOP	No data
				0.54	6–14 yr: PVI	No data
				0.60	6–14 yr: ΔPP	No data
				0.60	6–14 yr: PPV	No data
Hoiseth et al. [33]	250 mL colloid	Esophageal doppler	SV ≥ 15%	0.67	ΔPP: 8.8%	82/67
				0.72	ΔPOP: 11.4%	86/67
Hood and wilson [34]	500 mL colloid	Esophageal doppler	SV ≥ 10%	0.96	PVIfinger (baseline) 10%	86/100
				0.98	PVIearlobe (baseline) 9.5%	95/100
				0.71	PVIfinger (during surgery) 10%	65/67
				0.54	PVIearlobe (during surgery)

ΔPOP: pulse oximetry plethysmography; ΔPP: pulse pressure; PVI: Pleth variability index; CI: cardiac index; SV: stroke volume; SVI: stroke volume index; SVV: stroke volume variation; CO: cardiac output; PPVfina: pulse pressure variation obtained with Finapres; PPVart: pulse pressure variation obtained with intraarterial equipment; PPV/NPV: positive predictive value/negative predictive value.