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Expiratory reserve volume maneuver may be the preferred method for some patients during spirometry testing.
In 8 patients, the PAOP corresponding to preload reserve volume was elevated (20 to 25 mmHg).
This point at which additional fluid failed to cause noticeable increases in left ventricular end-diastolic area and fractional area change was defined as the preload reserve volume.
Measurements and Main Results: The mean PAOP for all patients at the time of achieving preload reserve volume was 18.6 ± 2.9 mmHg.
After reaching the preload reserve volume, the PAOP was measured, as were the systolic blood pressure, left ventricular fractional area change, and end-diastolic area.
Main Outcome Measures: Measures taken were the maximal expired pressure at total lung capacity (MEP-TLC) and at functional residual capacity (MEP-FRC), expiratory reserve volume (ERV), and the forced expiratory flow rate at TLC (FEF-TLC) and at FRC (FEF-FRC) by subjects' voluntary maximal efforts.
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Conclusions: In patients with well-preserved left ventricular function and normal wall thickness, preload reserve volumes subjectively determined by TEE corresponded to a range of filling pressures historically targeted to maximize cardiac performance (13 to 19 mmHg).
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