Background: Goal-directed volume expansion is increasingly used for fluid management in mechanically ventilated patients. The Pleth Variability Index (PVI) has been shown to reliably predict preload responsiveness; however, a lot of research on PVI has been published recently, and update of the meta-analysis needs to be completed. Methods: We searched PUBMED, EMBASE, Cochrane Library, Web of Science (updated to November 7, 2018) and the associated references. We also contacted relevant authors and researchers. Results: Twenty-five studies with 975 patients were included in this meta-analysis. All patients were mechanically ventilated. The area under the curve (AUC) of receiver operating characteristics (ROC) to predict preload responsiveness in patients was 0.82 (95% confidence interval (CI) 0.79 - 0.85). The pooled sensitivity was 0.77 (95% CI 0.67-0.85) and the pooled specificity was 0.77 (95% CI 0.71-0.82). The results of subgroup of patients without undergoing surgery (AUC =0.86, Youden index =0.65) and the results of subgroup of patients in ICU (AUC =0.89, Youden index =0.67) were reliable. Conclusion: The reliability of the PVI is limited, but the PVI can play an important role in bedside monitoring for mechanically ventilated patients who are not undergoing surgery. Patients who are expanded with colloid may be more suitable for PVI.

Background: Goal-directed volume expansion is increasingly used for fluid management in mechanically ventilated patients. The Pleth Variability Index (PVI) has been shown to reliably predict preload responsiveness; however, a lot of research on PVI has been published recently, and update of the meta-analysis needs to be completed. Methods: We searched PUBMED, EMBASE, Cochrane Library, Web of Science (updated to November 7, 2018) and the associated references. We also contacted relevant authors and researchers. Results: Twenty-five studies with 975 patients were included in this meta-analysis. All patients were mechanically ventilated. The area under the curve (AUC) of receiver operating characteristics (ROC) to predict preload responsiveness in patients was 0.82 (95% confidence interval (CI) 0.79 - 0.85). The pooled sensitivity was 0.77 (95% CI 0.67-0.85) and the pooled specificity was 0.77 (95% CI 0.71-0.82). The results of the without undergoing surgery subgroup (AUC =0.86, Youden index =0.65) and ICU subgroup (AUC =0.89, Youden index =0.67) were reliable. Conclusion: The reliability of the PVI is limited, but the PVI can play an important role in bedside monitoring for mechanically ventilated patients who are not undergoing surgery. Patients who are expanded with colloid and patients who undergoing cardiac surgery may be more suitable for PVI.

Background: Goal-directed volume expansion is increasingly used for fluid management in mechanically ventilated patients. The Pleth Variability Index (PVI) has been shown to reliably predict preload responsiveness; however, a lot of research on PVI has been published recently, and new meta-analysis needs to be updated. Methods: We searched PUBMED, EMBASE, Cochrane Library, Web of Science (updated to November 7, 2018) and the associated references. We also contacted relevant authors and researchers. Results: Twenty-five studies with 975 patients were included in this meta-analysis. All patients were mechanically ventilated. The pooled area under the receiver operating characteristic (AUC) to predict preload responsiveness in patients was 0.82 (95% confidence interval (CI) 0.79 - 0.85). The pooled sensitivity was 0.77 (95% CI 0.67-0.85) and the pooled specificity was 0.77 (95% CI 0.71-0.82). The results of the without undergoing surgery subgroup (AUC =0.86, Youden index =0.65) and ICU subgroup (AUC =0.89, Youden index =0.67) were reliable. Conclusion: The reliability of the PVI is limited, but the PVI can plays an important role in bedside monitoring for mechanically ventilated patients who are not undergoing surgery. Keywords: Pleth variability index, Preload responsiveness, Mechanically ventilated patients, Meta-analysis.

Background: Goal-directed volume expansion is increasingly used for fluid management in mechanically ventilated patients. The Pleth Variability Index (PVI) has been shown to reliably predict preload responsiveness; however, a lot of research on PVI has been published recently, and update of the meta-analysis needs to be completed. Methods: We searched PUBMED, EMBASE, Cochrane Library, Web of Science (updated to November 7, 2018) and the associated references. We also contacted relevant authors and researchers. Results: Twenty-five studies with 975 patients were included in this meta-analysis. All patients were mechanically ventilated. The area under the curve (AUC) of receiver operating characteristics (ROC) to predict preload responsiveness in patients was 0.82 (95% confidence interval (CI) 0.79 - 0.85). The pooled sensitivity was 0.77 (95% CI 0.67-0.85) and the pooled specificity was 0.77 (95% CI 0.71-0.82). The results of subgroup of patients without undergoing surgery (AUC =0.86, Youden index =0.65) and the results of subgroup of patients in ICU (AUC =0.89, Youden index =0.67) were reliable. Conclusion: The reliability of the PVI is limited, but the PVI can play an important role in bedside monitoring for mechanically ventilated patients who are not undergoing surgery. Patients who are expanded with colloid may be more suitable for PVI.

Background: Goal-directed volume expansion is increasingly used for fluid management in mechanically ventilated patients. The Pleth Variability Index (PVI) has been shown to reliably predict preload responsiveness; however, a lot of research on PVI has been published recently, and update of the meta-analysis needs to be completed. Methods: We searched PUBMED, EMBASE, Cochrane Library, Web of Science (updated to November 7, 2018) and the associated references. We also contacted relevant authors and researchers. Results: Twenty-five studies with 975 patients were included in this meta-analysis. All patients were mechanically ventilated. The area under the curve (AUC) of receiver operating characteristics (ROC) to predict preload responsiveness in patients was 0.82 (95% confidence interval (CI) 0.79 - 0.85). The pooled sensitivity was 0.77 (95% CI 0.67-0.85) and the pooled specificity was 0.77 (95% CI 0.71-0.82). The results of subgroup of patients without undergoing surgery (AUC =0.86, Youden index =0.65) and the results of subgroup of patients in ICU (AUC =0.89, Youden index =0.67) were reliable. Conclusion: The reliability of the PVI is limited, but the PVI can play an important role in bedside monitoring for mechanically ventilated patients who are not undergoing surgery. Patients who are expanded with colloid may be more suitable for PVI.