Surgery
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The response to a rapidly administered volume infusion (250 ml of 5% albumin over 30 minutes) was studied in 28 critically ill patients. Cardiovascular responses were assessed by means of invasive hemodynamic parameters (i.e., cardiac index [CI], central venous pressure [CVP], pulmonary artery pressure [PAP], and pulmonary capillary wedge [PCWP] pressure as well as radionuclide [RN] angiography). This allowed for the simultaneous measurement of right (RVEF) and left (LVEF) ejection fractions, and right (RVEDV) and left end-diastolic (LVEDV) and end-systolic (LVESV) volumes. ⋯ Clinical assessment of LV filling pressures (PCWP) does not accurately predict the response to volume infusion and does not allow a reliable assessment of the LV preload. This is most likely due to the broad range of LV compliance characteristics noted in critically ill patients. RV function also appears to be important in the clinical response to volume challenge.