Critical care management of the patient with pulmonary hypertension

Christopher F Barnett; Connor O'Brien; Teresa De Marco

doi:10.1093/ehjacc/zuab113

Critical care management of the patient with pulmonary hypertension

Eur Heart J Acute Cardiovasc Care. 2022 Jan 12;11(1):77-83. doi: 10.1093/ehjacc/zuab113.

Authors

Christopher F Barnett¹, Connor O'Brien¹, Teresa De Marco¹

Affiliation

¹ Department of Medicine, Cardiology Division, University of California, San Francisco, 505 Parnassus Avenue, Room S1134A, San Francisco, CA 94143, USA.

PMID: 34966914
DOI: 10.1093/ehjacc/zuab113

Abstract

Pulmonary hypertension (PH) is a common diagnosis in patients admitted to the cardiac intensive care unit with a wide range of underlying causes. A detailed evaluation to identify all factors contributing to the elevated pulmonary artery pressure and provide an assessment of right ventricular haemodynamics and function is needed to guide treatment and identify patients at highest risk for poor outcomes. While in many patients management of underlying and triggering medical problems with careful monitoring is appropriate, a subset of patients may benefit from specialized treatments targeting the pulmonary circulation and support of the right ventricle. In such cases, collaboration with or transfer to a centre with special expertise in the management of PH may be warranted.

Keywords: cardiogenic shock; extracorporeal membrane oxygenation; prostacyclins; pulmonary vascular resistance; right ventricular failure; Pulmonary hypertension.

MeSH terms

Critical Care
Heart Ventricles
Humans
Hypertension, Pulmonary* / diagnosis
Hypertension, Pulmonary* / therapy
Intensive Care Units
Ventricular Dysfunction, Right* / diagnosis
Ventricular Dysfunction, Right* / etiology
Ventricular Dysfunction, Right* / therapy