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Update on preload indexes: More volume than pressure

  • G. Della Rocca
  • M. G. Costa
  • L. Spagnesi
Conference paper

Abstract

Hemodynamic assessment is of primary importance in guiding volume therapy and vasoactive drug administration to optimize organ perfusion and to avoid fluid overload with lung edema in critically ill patients [1, 2]. Clinical examination has been shown to be of minimal value in detecting inadequate cardiac preload [3]. Several methods for preload determination, such as central venous pressure (CVP) and pulmonary artery occlusion pressure (PAOP), have been widely used [4]. Cardiac filling pressures are not always accurate indicators of ventricular preload because of erroneous readings of pressure tracings, discrepancy between measured and transmural pressures, and changes in ventricular compliance [5]. In recent years, right ventricular end-diastolic volume (RVEDV) evaluated by fast response pulmonary artery catheters (PACs), left ventricular end-diastolic area (LVEDA) measured by echocardiography, and the intrathoracic blood volume (ITBV) evaluated by the transpulmonary indicator dilution technique, have been proposed to assess cardiac preload at the bedside [6, 7, 8].

Keywords

Central Venous Pressure Stroke Volume Index Extravascular Lung Water Cardiac Preload Intrathoracic Blood Volume 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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Copyright information

© Springer-Verlag Berlin Heidelberg 2009

Authors and Affiliations

  • G. Della Rocca
    • 1
  • M. G. Costa
    • 1
  • L. Spagnesi
    • 1
  1. 1.Department of Anesthesia and Intensive CareAzienda Ospedaliero-Universitaria S.M. della MisericordiaUdineItaly

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