Critical Care Management of the Patient with Pulmonary Hypertension

Christopher J Mullin; Corey E Ventetuolo

doi:10.1016/j.ccm.2020.11.009

Critical Care Management of the Patient with Pulmonary Hypertension

Clin Chest Med. 2021 Mar;42(1):155-165. doi: 10.1016/j.ccm.2020.11.009.

Authors

Christopher J Mullin¹, Corey E Ventetuolo²

Affiliations

¹ Department of Medicine, Brown University, 593 Eddy Street, POB Suite 224, Providence, RI 02903, USA.
² Department of Medicine, Brown University, 593 Eddy Street, POB Suite 224, Providence, RI 02903, USA; Department of Health Services, Policy, and Practice, Brown University, 593 Eddy Street, POB Suite 224, Providence, RI 02903, USA. Electronic address: corey_ventetuolo@brown.edu.

PMID: 33541609
DOI: 10.1016/j.ccm.2020.11.009

Abstract

Pulmonary hypertension patients admitted to the intensive care unit have high mortality, and right ventricular failure typically is implicated as cause of or contributor to death. Initial care of critically ill pulmonary hypertension patients includes recognition of right ventricular failure, appropriate monitoring, and identification and treatment of any inciting cause. Management centers around optimization of cardiac function, with a multipronged approach aimed at reversing the pathophysiology of right ventricular failure. For patients who remain critically ill or in shock despite medical optimization, mechanical circulatory support can be used as a bridge to recovery or lung transplantation.

Keywords: Extracorporeal membrane oxygenation; Pulmonary arterial hypertension; Pulmonary hypertension; Right ventricular assist device; Right ventricular failure.

Publication types

Review

MeSH terms

Critical Care / methods*
Critical Illness
Heart Failure / etiology
Heart Failure / therapy
Humans
Hypertension, Pulmonary / therapy*
Intensive Care Units