The results of this systematic review and meta-analysis indicate that a volume responsiveness (VR) guided resuscitation strategy in sepsis patients confers no mortality benefit compared with usual care.

The methods of VR determination, and definitions thereof, differed among studies. While each approach is generally accurate when used appropriately, subtle differences between methods may affect pooled results. The direction of the effect is unknown but is likely smaller than the effect of patient-level differences owing to varied inclusion criteria. Data presentation from included studies was variable, precluding quantitative analysis of all secondary outcomes.

Various databases were searched, including PubMed, EMBASE, CINAHL, Web of Science, Cochrane Library, and Google Scholar from inception until April 2018.

The study selection included prospective studies of patients with sepsis, severe sepsis, or septic shock that compared volume responsiveness-guided fluid resuscitation to standard techniques and reported mortality data.

Of the 1,224 abstracts and 31 full-texts evaluated, four studies (total 365 patients) met inclusion criteria.

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