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Modulating the pulmonary circulation: an update.
MedLine Citation:
PMID:  17021443     Owner:  NLM     Status:  PubMed-not-MEDLINE    
PURPOSE OF REVIEW: Disorders of the pulmonary circulation might develop as a primary disease process of the pulmonary vascular bed or, more often, as the acute or chronic consequence of pulmonary or cardiac pathologies. For the anaesthesiologist and intensivist it is particularly interesting to gain insight into the regulation of the pulmonary circulation since pulmonary hypertension and concomitant right heart failure contribute to high perioperative mortality rates in patients at risk, especially after cardiac surgery. Therefore, modulation of the pulmonary circulation may be a life-saving therapy in patients suffering from acute or chronic pulmonary circulatory disorders. Furthermore, routinely performed intra-operative interventions such as the use of volatile anaesthetics or cardiopulmonary bypass systems may have relevant side effects on the pulmonary circulation. RECENT FINDINGS: This review focuses on new insights into the modulation of pulmonary circulation during general anaesthesia with volatile anaesthetics and anaesthesiological management during cardiopulmonary surgery. Recent publications in the field of cardiopulmonary bypass surgery, one-lung ventilation and heart and lung transplantation are discussed. Furthermore, the role of conventional and experimental therapeutic strategies to modulate pulmonary circulation in intensive care medicine is reviewed. SUMMARY: Despite the performance of a large number of clinical and experimental studies, the pathophysiology of pulmonary circulatory disorders is not completely understood. Therefore, any new therapy has to be carefully evaluated as a therapeutic option. Several formerly experimental therapeutic interventions such as inhaled vasodilators, however, appear to have found their way into clinical practice for selected indications.
Rolf Dembinski; Rolf Rossaint; Ralf Kuhlen
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Current opinion in anaesthesiology     Volume:  16     ISSN:  0952-7907     ISO Abbreviation:  Curr Opin Anaesthesiol     Publication Date:  2003 Feb 
Date Detail:
Created Date:  2006-10-05     Completed Date:  2007-06-20     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8813436     Medline TA:  Curr Opin Anaesthesiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  59-64     Citation Subset:  -    
Department of Anaesthesiology, University Hospital Aachen, Germany.
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