CARDIOVASCULAR SYSTEM: Edited by Thomas W.L. ScheerenWhere are we heading with fluid responsiveness research?Vistisen, Simon T.a,b,c; Juhl-Olsen, PeterbAuthor Information aResearch Centre for Emergency Medicine, Institute of Clinical Medicine, Aarhus University bDepartment of Anaesthesiology and Intensive Care, Aarhus University Hospital, Aarhus, Denmark cUniversity Medical Center Groningen, University of Groningen, Groningen, the Netherlands Correspondence to Simon T. Vistisen, PhD, MSc, Research Centre for Emergency Medicine, Aarhus University, Nørrebrogade 44, Building 30, 1st floor, 8000 Aarhus C, Denmark. Tel: +45 2067 6868; e-mail: [email protected] Current Opinion in Critical Care: August 2017 - Volume 23 - Issue 4 - p 318-325 doi: 10.1097/MCC.0000000000000421 Buy Metrics Abstract Purpose of review Fluid responsiveness prediction is not always possible with well established dynamic approaches such as passive leg raising or pulse pressure variation in the ICU. The purpose of the present review is to summarize emerging alternative techniques for fluid responsiveness prediction in adult critically ill patients and discuss their methodology and applicability. In addition, the future role of fluid responsiveness prediction in the ICU is discussed. Recent findings Several new dynamic techniques have been investigated and they all contribute to the applicability of fluid responsiveness techniques. Although increasing the applicability, most of the emerging techniques still rely on ventilator setting changes in patients that are fully or almost fully adapted to the ventilator or require reliable flow monitoring, which prevents broad applicability. Yet, the mini/micro fluid challenges and the use of extrasystolic preload changes have the potential of being more applicable but all reviewed methods need further validation and methodological refinement. Summary Emerging techniques are encouraging for broader applicability of fluid responsiveness prediction. Still, the clinical impact of correctly predicting fluid responsiveness remains to be investigated in the critically ill and the research community should have a clear aim of moving toward that type of studies. Copyright © 2017 Wolters Kluwer Health, Inc. All rights reserved.