EJV Occlusion Pressure Measurement to Assess Intravascular Volume in Cirrhotic Patients During IV Albumin Substitution

Inclusion Criteria: * In- and outpatients with liver cirrhosis of any etiology, diagnosed by either liver histology or compatible biochemical, imaging and clinical parameters, being treated at the department of Visceral Surgery and Medicine at Inselspital Bern, University Hospital Bern, Switzerland. * Age ≥ 18 years * Indication for IV albumin infusion according to current EASL guidelines\[11\] and BAVENO VII consensus recommendations\[12\] including large volume paracentesis, spontaneous bacterial peritonitis (SBP), AKI with/without HRS. * Available transthoracic echocardiography assessing right heart function within maximum 3 months from study inclusion. Exclusion Criteria: * Patients admitted to intermediate care unit or intensive care unit at the time of albumin infusion * Previous IV albumin infusion within the last 5 days * Contraindication to the PLR test (i.e. increased intracranial pressure) * Contraindication to albumin infusion (i.e. anaphylactic reactions against albumin) * History of right heart failure * Clinical evidence of lung edema, hemodynamic instability/shock * Anatomic IVC abnormalities, such as IVC stenosis and/or thrombosis * History of orthotopic liver transplant * Patients unable to provide informed consent