In the PAC-directed hemodynamic arm, therapy was adjusted to achieve specific hemodynamic goals in addition to the clinical goals in the Usual Group. These goals could include: pulmonary capillary wedge pressure (PCWP) 15 mm Hg or less; right atrial pressure 8mm Hg or less unless PCWP is 15 mm Hg or less; maintenance of systolic blood pressure of 80 or above, except for occasional transient decreases to lower levels after oral medications.