Respiratory pulse pressure variation fails to predict fluid responsiveness in acute respiratory distress syndrome

Table 3 Predictive performance of Δ_RESPPP according to chosen cutoff and fluid responsiveness definition^a

Definition of fluid responsiveness	Increase in CO >10% after volume expansion		Increase in CO >15% after volume expansion		Increase in CO >300 ml/min/m² after volume expansion
AUC for Δ_RESPPP	0.75 (0.62 to 0.85)		0.75 (0.63 to 0.85)		0.76 (0.63 to 0.84)
Cutoff for Δ_RESPPP	12%	5%^b	12%	5%^b	12%	4%^b
LR+	2 (0.8 to 4.9)	4.8 (3.6 to 6.2)	2.8 (1.2 to 6.8)	3.7 (2.8 to 4.9)	4.5 (2.2 to 9.5)	3.5 (2.6 to 4.7)
LR-	0.92 (0.3 to 2.8)	0.32 (0.1 to 0.8)	0.87 (0.3 to 2.6)	0.30 (0.1 to 0.8)	0.87 (0.1 to 6.0)	0.46 (0.2 to 1.1)
Se	0.15 (0.05 to 0.35)	0.73 (0.52 to 0.88)	0.19 (0.06 to 0.42)	0.76 (0.53 to 0.92)	0.16 (0.06 to 0.32)	0.62 (0.45 to 0.78)
Sp	0.92 (0.79 to 0.98)	0.85 (0.70 to 0.94)	0.93 (0.81 to 0.99)	0.80 (0.65 to 0.90)	0.96 (0.82 to 0.99)	0.82 (0.63 to 0.94)
PPV	0.57 (0.20 to 0.88)	0.76 (0.54 to 0.90)	0.57 (0.20 to 0.88)	0.64 (0.43 to 0.81)	0.86 (0.42 to 0.98)	0.82 (0.63 to 0.94)
NPV	0.62 (0.48 to 0.74)	0.83 (0.67 to 0.92)	0.71 (0.57 to 0.82)	0.88 (0.72 to 0.95)	0.47 (0.33 to 0.60)	0.62 (0.45 to 0.7)

^aCO, cardiac output; AUC, area under the receiver operating characteristic curve; Δ_RESPPP, respiratory changes in pulse pressure; LR+, positive likelihood ratio; LR-, negative likelihood ratio; Se, sensitivity; Sp, specificity; PPV; positive predictive value; NPV, negative predictive value; ^bbest cutoff identified in our study population. Ranges in parentheses represent 95% confidence intervals.

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