Background. Goal-directed fluid therapy reduces morbidity and mortality in various clinical settings. Respiratory variations in\r\nphotoplethysmography are proposed as a noninvasive alternative to predict fluid responsiveness during mechanical ventilation.\r\nThis paper aims to critically evaluate current data on the ability of photoplethysmography to predict fluid responsiveness.\r\nMethod. Primary searches were performed in PubMed, Medline, and Embase on November 10, 2011. Results. 14 papers\r\nevaluating photoplethysmography and fluid responsiveness were found. Nine studies calculated areas under the receiver operating\r\ncharacteristic curves for ?POP (>0.85 in four, 0.75ââ?¬â??0.85 in one, and <0.75 in four studies) and seven for PVI (values ranging\r\nfrom 0.54 to 0.98). Correlations between ?POP/PVI and ?PP/other dynamic variables vary substantially. Conclusion. Although\r\nphotoplethysmography is a promising technique, predictive values and correlations with other hemodynamic variables indicating\r\nfluid responsiveness vary substantially. Presently, it is not documented that photoplethysmography is adequately valid and reliable\r\nto be included in clinical practice for evaluation of fluid responsiveness.
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