💧 Fluid Responsiveness Assessment
UseUse during resuscitation to test responsiveness via passive leg raise, fluid challenge, or PPV/SVV before giv…
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SourceSurviving Sepsis Campaign 2021 — dynamic measures.
Runs locally in your browser (no PHI uploaded). For licensed clinicians — not a substitute for clinical judgement.
Stored on this device for revisit reminders
This-shift next steps
After scoring: open the scene pack, peer scores, and the matching pathway. Local reference — no HIS write.
Scene next step
📋fluid nutritionOpen scene pack →Related scores
Matching pathway
🧭ped_dehydrationOpen pathway →Score + version; reference only — not a substitute for care · no HIS write
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Methodology · worked example, guidelines & full notes
Clinical takeaway
PPV/SVV is only valid with controlled mechanical ventilation, sinus rhythm, and no spontaneous breathing — otherwise use PLR or a fluid challenge (original synthesis · not guideline verbatim).
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 (with applicability conditions), indicates fluid responsiveness; dynamic indices outperform static CVP.
Key points
- PPV/SVV is only valid with controlled mechanical ventilation, 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
Worked calculation
The values below come from this tool's own example placeholders and are computed server-side with the formula shown on this page, so the arithmetic can be checked quickly. It demonstrates how to substitute values only — it is not clinical advice and not a real case.
| Assessment method | Fluid challenge (250–500 mL, measure SV change) |
|---|---|
| Value (PLR/challenge = SV or CO increase %; PPV/SVV = variation %) | 12 % |
| PPV/SVV applicability (mechanical ventilation Vt, sinus rhythm, no spontaneous breathing, no right-heart failure/intra-abdominal hypertension) | Met (or not a PPV/SVV method) |
→Fluid responsivenessResponsive
- Determination：Fluid challenge (250–500 mL) produced a stroke-volume increase of 12% (threshold ≥ 10%) → fluid-responsive (a fluid bolus may increase cardiac output)
- Management direction：With evidence of hypoperfusion (high lactate/oliguria/prolonged CRT), give fluids cautiously and reassess; stop volume expansion once non-responsive or perfusion improves
- Note：Dynamic indices outperform static (CVP/single pressure predicts poorly). PLR and fluid challenge directly measure SV/CO change and remain applicable with spontaneous breathing and arrhythmia; PPV/SVV requires mechanical ventilation, sinus rhythm, no spontaneous breathing, no right-heart failure/intra-abdominal hypertension. Give fluids on this basis only with signs of hypoperfusion
| Assessment method | PPV / SVV (pulse-pressure / stroke-volume variation) |
|---|---|
| Value (PLR/challenge = SV or CO increase %; PPV/SVV = variation %) | 12 % |
| PPV/SVV applicability (mechanical ventilation Vt, sinus rhythm, no spontaneous breathing, no right-heart failure/intra-abdominal hypertension) | Not met |
→PPV/SVVUnreliable
- Determination：PPV/SVV is reliable only with mechanical ventilation, sinus rhythm, no spontaneous breathing trigger, and no severe right-heart failure/intra-abdominal hypertension; the current conditions are not met
- Recommendation：Switch to passive leg raise (PLR) or fluid challenge (directly measuring stroke-volume/cardiac-output change), which remain applicable with spontaneous breathing/arrhythmia
- Basis：Dynamic indices outperform static (CVP predicts poorly); PPV/SVV applicability conditions
Verification & sources · governance
FAQ
Frequently asked questions
- What are the limits and cautions when using Fluid Responsiveness Assessment?
- For licensed clinicians and clinical researchers. Interpret results with history, investigations and local protocols; not a diagnosis or prescription, and not a substitute for multidisciplinary decision-making or local guidelines.
- Does Fluid Responsiveness Assessment upload patient data? Where is it calculated?
- Calculation runs locally in the browser; inputs and results are not uploaded. For licensed clinicians only; interpret with history, investigations and local protocols — not a diagnosis or prescription.
- How is Fluid Responsiveness Assessment calculated in practice? Can you show a worked example?
- Inputs: Assessment method Fluid challenge (250–500 mL, measure SV change), Value (PLR/challenge = SV or CO increase %; PPV/SVV = variation %) 12 %, PPV/SVV applicability (mechanical ventilation Vt, sinus rhythm, no spontaneous breathing, no right-heart failure/intra-abdominal hypertension) Met (or not a PPV/SVV method) → Result: Fluid responsiveness Responsive（Determination: Fluid challenge (250–500 mL) produced a stroke-volume increase of 12% (threshold ≥ 10%) → fluid-responsive (a fluid bolus may increase cardiac output), Management direction: With evidence of hypoperfusion (high lactate/oliguria/prolonged CRT), give fluids cautiously and reassess; stop volume expansion once non-responsive or perfusion improves, Note: Dynamic indices outperform static (CVP/single pressure predicts poorly). PLR and fluid challenge directly measure SV/CO change and remain applicable with spontaneous breathing and arrhythmia; PPV/SVV requires mechanical ventilation, sinus rhythm, no spontaneous breathing, no right-heart failure/intra-abdominal hypertension. Give fluids on this basis only with signs of hypoperfusion） Inputs: Assessment method PPV / SVV (pulse-pressure / stroke-volume variation), Value (PLR/challenge = SV or CO increase %; PPV/SVV = variation %) 12 %, PPV/SVV applicability (mechanical ventilation Vt, sinus rhythm, no spontaneous breathing, no right-heart failure/intra-abdominal hypertension) Not met → Result: PPV/SVV Unreliable（Determination: PPV/SVV is reliable only with mechanical ventilation, sinus rhythm, no spontaneous breathing trigger, and no severe right-heart failure/intra-abdominal hypertension; the current conditions are not met, Recommendation: Switch to passive leg raise (PLR) or fluid challenge (directly measuring stroke-volume/cardiac-output change), which remain applicable with spontaneous breathing/arrhythmia, Basis: Dynamic indices outperform static (CVP predicts poorly); PPV/SVV applicability conditions）