Assess fluid responsiveness by calculating augmented pulse pressure variation. Augmentation maneuvers improve the sensitivity and specificity of pulse pressure variation for detecting fluid responsiveness. Record an initial systolic and diastolic pressure and then systolic and diastolic pressure in response to an augmentation maneuver such as a valsalva maneuver.

Valsalva Maneuver: Published evidence has shown the threshold for fluid responsiveness is PPVvm > 52% in spontaneously breathing patients, and PPVvm>55% in open chest conditions in response to a sustained positive pressure of 30 cmH2O for 10 seconds.