Skip to main content

Fluid responsiveness during weaning from mechanical ventilation


To overcome the limited accuracy of functional hemodynamic parameters such as stroke volume and pulse pressure variation (SVV and PPV) during spontaneous breathing, a passive leg raising (PLR) maneuver has been suggested as a reliable predictor of fluid responsiveness [1, 2]. The aim of this study was to evaluate fluid responsiveness using SVV, PPV and PLR during the transition from controlled to spontaneous breathing.


Thirty-four patients after off-pump CABG were enrolled. Measurements were performed in the ICU using a PiCCO2 system. Fluid (500 ml) was given: (A) during controlled mechanical ventilation, (B) during pressure support ventilation with spontaneous breathing and (C) after extubation. The stroke volume (SV), SVV and PPV as well as the mean arterial pressure and heart rate were assessed. A PLR was performed before fluid administration at all three time points. Fluid response was defined as an increase in SV >15%. Prediction of fluid responsiveness was tested using ROC analysis.


In 34 patients significant hemodynamic changes were observed, with 19 (55.9%), 22 (64.7%), and 13 (40.6%) responders at time points A, B and C, respectively. Prediction of fluid responsiveness is depicted in Table 1.

Table 1 Prediction of fluid responsiveness


Prediction of a fluid response with SVV/PPV was less reliable in spontaneous breathing. PLR predicted fluid responsiveness, but was less accurate than previously reported.


  1. Marik , et al.: Crit Care Med. 2009, 37: 2642-2647. 10.1097/CCM.0b013e3181a590da

    Article  PubMed  Google Scholar 

  2. Monnet , et al.: Crit Care Med. 2006, 34: 1402-1407. 10.1097/01.CCM.0000215453.11735.06

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations


Rights and permissions

This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit The Creative Commons Public Domain Dedication waiver ( applies to the data made available in this article, unless otherwise stated in a credit line to the data.

Reprints and Permissions

About this article

Cite this article

Geisen, M., Schmid, U., Dzemali, O. et al. Fluid responsiveness during weaning from mechanical ventilation. Crit Care 16, P236 (2012).

Download citation

  • Published:

  • DOI:


  • Mechanical Ventilation
  • Stroke Volume
  • Support Ventilation
  • Pressure Support
  • Spontaneous Breathing