Table 2.
Characteristics of included studies addressing echocardiography maneuvers, pulse contour analysis or noninvasive cardiac output monitor (NICOM®) for fluid responsiveness in spontaneously breathing patients
| Author, year | N | Setting | Inclusion criteria | Exclusion criteria | Ventilation | Fluid challenge | Definition of responders | Maneuvers |
|---|---|---|---|---|---|---|---|---|
| Lamia, 2007 [21] | 24 | ICU | 1. MAP < 60 mmHg 2. Tachycardia 3. UO < 0.5 ml/kg/h 4. Delayed CRT |
1. Aortic valvulopathy 2. Mitral insufficiency or stenosis |
SB and SBmv | 500 ml I.V. saline for 15 min | ↑SVi ≥ 15% | 1. SVi-PLR by TE |
| Maizel, 2007 [22] | 34 | ICU | 1. Hypotension 2. Acute renal failure 3. Dehydration |
1. Hemorrhage 2. PLR contraindications 3. Arrhythmia |
SB | 500 ml I.V. saline over 15 min | ↑CO ≥ 12% | 1. ∆CO-PLR by TE 2. ∆SV-PLR by TE |
| Biais, 2009 [23] | 30 | ICU | 1. SBP < 90 mmHg 2. Tachycardia 3. Acute renal failure 4 Mottled skin |
1. ↑ intra-abdominal pressure 2. BMI < 15 or > 40 kg/m2 3. Valvulopathy 4 Intracardiac shunt |
SB and SBmv | 500 ml I.V. saline for 15 min | ↑SV > 15% | 1. ∆SV-PLRTE by TE 2. ∆SV-PLRFloT by PCA |
| Muller, 2012 [24] | 40 | ICU | 1. MAP < 65 mmHg 2. Tachycardia 3. UO < 0.5 mL/Kg/h 4. Mottled skin |
1. Pulmonary edema 2. Right ventricular failure 3. Elevated left atrial pressure |
SB | 500 mL I.V. 6% HES over 15 min | ↑VTI ≥ 15% | 1. cIVC by TE 2. E wave velocity by TE |
| Brun, 2013 [25] | 23 | ICU | 1. Severe preeclampsia | 1. Cardiac or renal disorders prior to pregnancy | SB | 500 ml I.V. saline over 15 min | ↑SVi ≥ 15% | 1. ∆VTI-PLR 2. VTI |
| Lanspa, 2013 [26] | 14 | ICU | 1. Age ≥ 14 years 2. Infection and SIRS 3. Refractory hypotension |
1. Pregnancy 2. Aortic stenosis 3. Arrhythmia 4. COPD and asthma |
SB | 10 mL/kg of I.V. crystalloids over 20 min | ↑CI ≥ 15% | 1. cIVC by TE 2. ∆SV by PCA 3. AoVV by TE |
| Airapetian, 2015 [27] | 59 | ICU | 1. Physician decided to perform fluid expansion | 1. Hemorrhage 2. Arrhythmia 3. Compression stockings 4. PLR contraindications |
SB | PLR and 500 ml I.V. saline over 15 min | ↑CO ≥ 10% | 1. cIVC by TE 2. IVCmax by TE 3. ΔCO-PLR by TE |
| Duus, 2015 [29] | 100 | ED | 1. Age ≥ 18 years 2. Clinical team intended to administer IV fluid |
1. Acuity precluding participation in research 2 PLR contraindications |
SB | 5 ml/kg I.V. saline | ↑SV > 10% | 1. ∆SV-PLR using NICOM® |
| Corl, 2017 [28] | 124 | ED and ICU | 1. PAS < 90 mmHg 2. Tachycardia 3. UO < 0.5 ml/kg/h 4. Hypoperfusion |
1. Cardiogenic, obstructive or neurogenic shock 2. Age < 18 years 3. Hospitalization for > 36 h |
SB | 500 ml I.V. saline | ↑CI ≥ 10% | 1. cIVC by TE |
ICU intensive care unit, ED emergency department, MAP mean arterial pressure, UO urine output, CRT capillary refill time, SBP systolic blood pressure, PLR passive leg raising, ↑ = increase, BMI body mass index, COPD chronic obstructive pulmonary disease, SB spontaneous breathing without any ventilatory support, SBmv mechanical ventilation during spontaneous mode, I.V. intravenous, HES hydroxyethyl starch, SV stroke volume, CO cardiac output, VTI aortic velocity–time integral, SVi stroke volume index, CI cardiac index, PLR passive leg raising, SVi-PLR PLR-induced change in stroke volume index, TE transthoracic echocardiography, ΔCO change in cardiac output, ΔCO-PLR ΔCO between baseline and after PLR, ∆SV stroke volume variation, ∆SV-PLR PLR-induced change in stroke volume, FloT FloTrac™, PCA pulse contour analysis, cIVC inferior vena cava collapsibility index, VTI aortic velocity–time integral, ∆VTI-PLR VTI variations during PLR, AoVV aortic velocity variation, NICOM® noninvasive cardiac output monitor, IVCmax inferior vena cava maximum diameter