Increased Preload: Hypervolemia

• Increased CVP/PAWP • Ventricular failure (AMI)

• Variable SV/SI • Renal failure

• Variable CO/CI • Fluid overload

• Variable SvO2

• Pulmonary congestion

• Relieve pulmonary congestion

• Expected response

• Decreased CVP/PAWP

• Increase SV/SI

• Increase CO/CI

• Relieve pulmonary congestion

• Increased SvO2

• Diuretics

• furosemide (Lasix)

• bumetanide (Bumex)

• Venodilators

• nitroglycerin

• Caution: excess preload reduction may result in decreased SV/SI, CO/CI, & SVO2

• When given IV, dose may be extremely variable (10mg to 200mg)

• Frequency based on patient response

• May be given as continuous infusion

• Monitor electrolytes

• Venodilator

• Wide range of dosing (5mcg/min to 400mcg/min)

• Titrate IV from lowest dose

• Rapid onset of action

• Short half-life

• Improves coronary blood flow