The present invention relates to a device, system and method for determining pulse pressure variation of a subject. To enable more reliably determining pulse pressure variation of a subject the device comprises a signal input (11) configured to obtain an input signal representing a hemodynamic signal of the subject, a processor (12) configured to process the input signal and compute a pulse pressure variation and a signal output (13) configured to output the computed pulse pressure variation. The pulse pressure variation is computed by deriving a pulse height signal from the input signal, deriving a pulse height baseline and a de-trended pulse height signal from the pulse height signal as the ratio between the difference between extrema of the de-trended pulse height signal and the respective value of the pulse height baseline signal, and computing the pulse pressure variation from the de-trended pulse height signal and the pulse height baseline.