Current strategies for optimizing right ventricular preload in the management of acute right ventricle failure.

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.