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How to measure and interpret volumetric measures of preload

Rocca, Giorgio Della; Costa, Maria Gabriella; Pietropaoli, Paolo

Current Opinion in Critical Care: June 2007 - Volume 13 - Issue 3 - p 297–302
doi: 10.1097/MCC.0b013e32811d6ce3
Cardiopulmonary monitoring

Purpose of review To update the situation over the past few years on the clinical application of volumetric measures of preload in critically ill patients.

Recent findings Cardiac filling pressures monitoring is unreliable for assessing cardiac preload in mechanically ventilated critically ill patients. The transpulmonary dilution indicator technique was shown to better identify preload than pulmonary arterial catheterization. Measuring static preload index as intrathoracic blood volume or global end diastolic volume provides a good preload index, either in experimental or in different clinical settings.

Summary Volumetric measures of preload are good preload indexes. These data are to be interpreted together with the clinical patient's condition, conventional hemodynamic data and the course of illness in critically ill patients. In order to evaluate whether the application of a predefined therapy algorithm based on volumetric monitoring can improve patients’ outcome, more studies are needed.

Department of Anesthesia and Intensive Care Medicine, University of Udine, Udine, Italy

Correspondence to Giorgio Della Rocca, MD, C.so Trieste 169/A, 00198 Rome, Italy Tel: +39 0432 559500 1; fax: +39 0432 545526; e-mail: giorgio.dellarocca@uniud.it

© 2007 Lippincott Williams & Wilkins, Inc.