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Chinese Journal of Critical Care & Intensive Care Medicine(Electronic Edition) ›› 2019, Vol. 05 ›› Issue (01): 39-45. doi: 10.3877/cma.j.issn.2096-1537.2019.01.008

Special Issue:

• Critical Care Research • Previous Articles     Next Articles

End-expiratory occlusion test for predicting fluid responsiveness: a systematic review and meta-analysis based on international databases

Ming Gao1, Hua Zhou1,(), Zhe Guo1, Sheng Wu1, Yuan Xu1   

  1. 1. Department of Critical Care Medicine, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine Tsinghua University, Beijing 102218, China
  • Received:2018-01-20 Online:2019-02-28 Published:2019-02-28
  • Contact: Hua Zhou
  • About author:
    Corresponding author: Zhou Hua, Email:

Abstract:

Objective

To determine the predictive value of the end-expiratory occlusion test (EEOT) in fluid responsiveness evaluation by performing a systematic review and meta-analysis of studies.

Methods

Databases including PubMed, Embase and Cochrane Database were searched for relevant clinical trials before October 2017. Two independent investigators extracted data and study characteristics. Bivariate mixed-effects regression model was used to estimate the pooled sensitivity, specificity, positive and negative likelihood ratio and diagnostic odds ratio with 95% CIs. The SROC curve and Fagan graphs were produced, and the area under the curve was also calculated. Meanwhile, we calculated relative diagnostic odds ratio (RDOR) to compare diagnostic value of EEOT and PPV.

Results

Seven studies (260 adult patients, 270 fluid challenges) were included. Fluid challenge test was used as standard reference in all studies. For the EEOT-induced changes in CO or its surrogate, the pooled sensitivity was 0.93 (95%CI: 0.86-0.96) and the pooled specificity was 0.90 (95%CI: 0.81-0.95). The area under the ROC curve was 0.97 (95%CI: 0.95-0.98). Four studies which compared EEOT and PPV at the same time, the RDOR was 3.13 (P=0.24).

Conclusion

EEOT-induced changes in CO or its surrogate can very reliably predict the response of CO to volume expansion in adult patients. There is no significant difference between the diagnostic value of EEOT and PPV.

Key words: End-expiratory occlusion test, Pulse pressure variation, Fluid challenge test, Fluid responsiveness, Meta-analysis

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