Preload Interventions

There are many variables that affect the preload status of the heart and multiple preload interventions that can be used to either increase or decrease preload status. Some examples are:

Increase (through administration of volume expanders)

Hypertonic saline – inexpensive, has anti-inflammatory effects, requires close monitoring and frequent lab draws
Normal saline – inexpensive, commonly used, requires move volume than hypertonic saline
Lactate ringers – likely has pro-inflammatory effects
Hespan/hetastarch – amount limited by effects on kidney and platelets, moderately cost
Albumin – expensive, has pro-inflammatory effects, minute risk of disease transmission
Blood products – expensive, pro-inflammatory, use should be restricted to actively bleeding patients and other well-defined criteria