Key result
Integrating multiple hemodynamic indices rather than isolated CVP optimizes acute RV failure management.
Management of acute right ventricular failure requires a comprehensive approach integrating multiple hemodynamic indices rather than relying solely on central venous pressure to optimize RV preload.
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Supports integrated hemodynamic assessment in acute RV failure; leaves open need for prospective trials before practice change.
In this review of right ventricular (RV) preload, we discuss RV physiology, assessment of RV preload, and optimization of RV preload in the setting of acute RV failure. Early recognition and ongoing reassessment of invasive or noninvasive hemodynamics are critical to the management of acute RV failure. Central venous pressure (CVP) estimates RV preload but should not be the sole parameter guiding management. A comprehensive approach that integrates multiple hemodynamic indices should be considered to guide the resuscitative process in acute RV failure.
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Cao et al. (2026) studied this question. Integrating multiple hemodynamic indices, rather than relying solely on CVP, is crucial in the management of acute right ventricular failure.
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