💧 Fluid Responsiveness Assessment
Dynamic fluid-responsiveness assessment to guide whether further fluids will increase cardiac output.
Fluid Responsiveness Assessment
Assessment method
Value (PLR/challenge = SV or CO increase %; PPV/SVV = variation %) (%)
PPV/SVV applicability (mechanical ventilation Vt ≥ 8, sinus rhythm, no spontaneous breathing, no right-heart failure/intra-abdominal hypertension)
When to use
Use during resuscitation to test responsiveness via passive leg raise, fluid challenge, or PPV/SVV before giving more fluid.
How it works
Passive leg raise or 250–500 mL fluid challenge increasing stroke volume/cardiac output ≥ 10%, or PPV/SVV > 13% (with applicability conditions), indicates fluid responsiveness; dynamic indices outperform static CVP.
Key points
- PPV/SVV is only valid with controlled mechanical ventilation (Vt ≥ 8), sinus rhythm, and no spontaneous breathing — otherwise use PLR or a fluid challenge (original synthesis · not guideline verbatim).
- Responsiveness alone does not mandate fluids; give them only with concurrent signs of hypoperfusion.
- Static CVP predicts fluid responsiveness poorly and should not drive fluid decisions.
References
- Monnet X, Teboul JL. Passive leg raising. Intensive Care Med 2015.
- Surviving Sepsis Campaign 2021 — dynamic measures.
Decision support for licensed clinicians only; not a substitute for clinical judgement, diagnosis or local protocols.