A 65-year-old mechanically ventilated patient in the ICU is in sinus rhythm with no spontaneous breaths and a tidal volume of 8 mL/kg. An arterial line tracing shows a pulse pressure variation (PPV) of 18%. What does this value indicate?
- A The patient is volume unresponsive and will not benefit from fluid administration
- B The patient is volume responsive and will likely increase stroke volume with fluid administration ✓
- C The patient has severe left ventricular systolic dysfunction
- D The patient has cardiac tamponade physiology
Correct answer: B. The patient is volume responsive and will likely increase stroke volume with fluid administration
Explanation
In mechanically ventilated patients with sinus rhythm, no spontaneous breaths, and a tidal volume of at least 8 mL/kg, a PPV greater than 13% reliably predicts fluid responsiveness. The patient is on the ascending limb of the Frank-Starling curve. B value below 9% suggests fluid unresponsiveness. PPV does not diagnose ventricular dysfunction or tamponade.
Reference: Ganong's Review of Medical Physiology, 26th ed.
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