Esophageal Doppler monitoring predicts fluid responsiveness in critically ill ventilated patients
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Updated: Aug 16, 2026
Continuous Venous-Arterial Doppler Ultrasound During a Preload Challenge
Published on: January 20, 2023
Xavier Monnet1, Mario Rienzo, David Osman
1Service de Réanimation Médicale, Centre Hospitalo-Universitaire de Bicêtre, Assistance Publique-Hôpitaux de Paris, Université Paris XI, 78 rue du Général Leclerc, 94270 le Kremlin-Bicêtre, France.
Objective:
To test whether fluid responsiveness can be predicted by the respiratory variation in aortic blood flow and/or the flow time corrected for heart rate monitored with esophageal Doppler.
Design And Setting:
Prospective study in a 24-bed medical intensive care unit of a university hospital.
Patients:
38 mechanically ventilated patients with sinus rhythm and without spontaneous breathing activity in whom volume expansion was planned.
Interventions:
The aortic blood flow was measured using an esophageal Doppler monitoring device before and after fluid infusion (500 ml NaCl 0.9% over 10 min). The variation in aortic blood flow over a respiratory cycle between its minimal and maximal values was calculated. The flow time was also measured.
Measurements And Results:
Aortic blood flow increased by at least 15% after volume expansion in 20 patients (defined as responders). Before fluid infusion the respiratory variation in aortic flow was higher in responders than in nonresponders (28+/-12% vs. 12+/-5%). It significantly decreased after volume expansion (18+/-11%) in responders only. A respiratory variation in aortic flow before volume expansion of at least 18% predicted fluid responsiveness with a sensitivity of 90% and a specificity of 94%. Flow time increased with fluid infusion in responders and nonresponders. A flow time corrected for heart rate below 277 ms predicted fluid responsiveness with a sensitivity of 55% and a specificity of 94%. The area under the ROC curve generated for variation in aortic blood flow ABF was greater than that generated for flow time.
Conclusions:
The respiratory variation in aortic blood flow reliably predicts fluid responsiveness in patients with sinus rhythm and without breathing activity.
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