The present invention relates to physiological signal processing, and in particular to methods and systems for processing physiological signals to predict a fluid responsiveness of a patient. A medical monitor for monitoring a patient includes an input receiving a photoplethysmograph (PPG) signal representing light absorption by a patient's tissue. The monitor also includes a perfusion status indicator indicating a perfusion status of the PPG signal, and a fluid responsiveness predictor (FRP) calculator programmed to calculate an FRP value based on a respiratory variation of the PPG signal. The FRP calculator applies a correction factor based on the perfusion status indicator.