• L N Diebel, R F Wilson, M G Tagett, and R A Kline.
• Department of Surgery, Wayne State University, Detroit, MI 48201.
• Arch Surg Chicago. 1992 Jul 1; 127 (7): 817-21; discussion 821-2.

AbstractThe relative value of pulmonary artery wedge pressure (PAWP) and right ventricular end-diastolic volume index (RVEDVI) as a reflection of the preload status of the critically ill was determined in 29 patients. Regression analysis of 131 hemodynamic studies demonstrated that cardiac index (CI) correlated better with RVEDVI (r = .61) than did PAWP (r = .42). Comparisons of PAWP and RVEDVI showed that possible misleading information concerning filling volume was provided by the PAWP at some time in 15 (52%) of these patients. In 15 patients given 22 fluid challenges, patients with a high PAWP (greater than or equal to 18 mm Hg) "responded" with a rise in CI more frequently than did patients with a low PAWP (less than 12 mm Hg). However, all eight patients with a RVEDVI less than 90 mL/m2 responded with a rise in CI, but all seven patients with a RVEDVI greater than or equal to 139 mL/m2 failed to respond. Thus, RVEDVI more accurately predicted preload recruitable increases in cardiac output.

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