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Anesthesiol Res Pract. 2012; 2012: 617380.
Published online Feb 28, 2012. doi:  10.1155/2012/617380
PMCID: PMC3353145
Evaluation of Fluid Responsiveness: Is Photoplethysmography a Noninvasive Alternative?
Lars Prag Antonsen 1 * and Knut Arvid Kirkebøen 1 ,2
1Faculty of Medicine, University of Oslo, 0316 Oslo, Norway
2Department of Anesthesiology, Oslo University Hospital, Ullevaal, 0424 Oslo, Norway
*Lars Prag Antonsen: larspantonsen/at/hotmail.com
Academic Editor: Ronald G. Pearl
Received September 29, 2011; Revised November 29, 2011; Accepted December 21, 2011.
Abstract
Background. Goal-directed fluid therapy reduces morbidity and mortality in various clinical settings. Respiratory variations in photoplethysmography are proposed as a noninvasive alternative to predict fluid responsiveness during mechanical ventilation. This paper aims to critically evaluate current data on the ability of photoplethysmography to predict fluid responsiveness. Method. Primary searches were performed in PubMed, Medline, and Embase on November 10, 2011. Results. 14 papers evaluating photoplethysmography and fluid responsiveness were found. Nine studies calculated areas under the receiver operating characteristic curves for ΔPOP (>0.85 in four, 0.75–0.85 in one, and <0.75 in four studies) and seven for PVI (values ranging from 0.54 to 0.98). Correlations between ΔPOP/PVI and ΔPP/other dynamic variables vary substantially. Conclusion. Although photoplethysmography is a promising technique, predictive values and correlations with other hemodynamic variables indicating fluid responsiveness vary substantially. Presently, it is not documented that photoplethysmography is adequately valid and reliable to be included in clinical practice for evaluation of fluid responsiveness.
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