Document Detail

Pulmonary hypertension in the intensive care unit.
MedLine Citation:
PMID:  23009915     Owner:  NLM     Status:  MEDLINE    
Pulmonary hypertension, a condition that can lead to right ventricular failure and hemodynamic collapse, can be very challenging to manage in critically ill patients who require the intensive care unit. Because of the underlying structure of the right ventricle, significant increases in right ventricular afterload initiate a vicious cycle of degenerating right ventricular function, giving rise to right ventricular failure and cardiogenic shock. In patients with pulmonary hypertension, inciting factors such as sepsis and arrhythmias can exacerbate this process. Important management principles include close monitoring of hemodynamics with both noninvasive and invasive modalities, optimization of right ventricular preload, maintenance of systemic blood pressure, enhancement of right ventricular contractility, reduction of right ventricular afterload, and reversal of identifiable inciting factors. The goal of this review is to discuss these key concepts in managing this difficult patient population.
Hooman D Poor; Corey E Ventetuolo
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Progress in cardiovascular diseases     Volume:  55     ISSN:  1873-1740     ISO Abbreviation:  Prog Cardiovasc Dis     Publication Date:    2012 Sep-Oct
Date Detail:
Created Date:  2012-09-26     Completed Date:  2012-12-11     Revised Date:  2013-05-02    
Medline Journal Info:
Nlm Unique ID:  0376442     Medline TA:  Prog Cardiovasc Dis     Country:  United States    
Other Details:
Languages:  eng     Pagination:  187-98     Citation Subset:  AIM; IM    
Copyright Information:
Copyright © 2012 Elsevier Inc. All rights reserved.
Division of Pulmonary, Allergy and Critical Care Medicine, New York Presbyterian Hospital, Columbia University College of Physicians and Surgeons, New York, NY, USA.
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MeSH Terms
Cardiopulmonary Resuscitation / methods*
Heart Failure / etiology,  therapy*
Hypertension, Pulmonary / complications,  therapy*
Intensive Care Units*
Ventricular Dysfunction, Right / complications*,  therapy

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