Preoperative acute volume loading in patients with pheochromocytoma

Ten patients with pheochromocytoma underwent preoperative acute volume loading to determine whether fluid infusion severely increased pulmonary capillary wedge pressure without improving forward flow, and to provide a guide for intraoperative volume replacement. In one patient, volume loading confirmed baseline pressure data suggesting a discrepancy between right and left ventricular filling pressures. In a second patient with normal baseline wedge pressure, volume loading revealed an unsuspected ventricular dysfunction. During subsequent surgery, both volume and speed of fluid infusion were adapted to the preoperative ventricular response.