Decompensated right heart failure, intensive care and perioperative management in patients with pulmonary hypertension: Updated recommendations from the Cologne Consensus Conference 2018

Karen M Olsson; Michael Halank; Benjamin Egenlauf; David Fistera; Henning Gall; Christian Kaehler; Kathrin Kortmann; Thorsten Kramm; Mona Lichtblau; Alberto M Marra; Christian Nagel; Armin Sablotzki; Hans-Jürgen Seyfarth; Dietmar Schranz; Silvia Ulrich; Marius M Hoeper; Tobias J Lange

doi:10.1016/j.ijcard.2018.08.081

Decompensated right heart failure, intensive care and perioperative management in patients with pulmonary hypertension: Updated recommendations from the Cologne Consensus Conference 2018

Int J Cardiol. 2018 Dec 1:272S:46-52. doi: 10.1016/j.ijcard.2018.08.081. Epub 2018 Aug 26.

Authors

Karen M Olsson¹, Michael Halank², Benjamin Egenlauf³, David Fistera⁴, Henning Gall⁵, Christian Kaehler⁶, Kathrin Kortmann⁷, Thorsten Kramm⁸, Mona Lichtblau⁹, Alberto M Marra¹⁰, Christian Nagel¹¹, Armin Sablotzki¹², Hans-Jürgen Seyfarth¹³, Dietmar Schranz¹⁴, Silvia Ulrich⁹, Marius M Hoeper¹⁵, Tobias J Lange¹⁶

Affiliations

¹ Department of Respiratory Medicine, Hannover Medical School, Hannover, Germany, German Centre for Lung Research (DZL), Germany. Electronic address: olsson.karen@mh-hannover.de.
² Medical Clinic 1/Pneumology, University Hospital Carl Gustav Carus, Dresden, Germany.
³ Department of Internal Medicine, Pulmonology and Critical Care Medicine, Thorax Clinic at the University Hospital Heidelberg, Heidelberg, Germany.
⁴ Clinic for Pneumology, Ruhrlandklinik/University Hospital Essen, Germany.
⁵ University of Giessen and Marburg Lung Center (UGMLC), member of the German Center for Lung Research (DZL), Giessen, Germany.
⁶ Department of Pneumology, Critical Care and Allergology, Lung Centre South-West, Wangen im Allgäu, Germany.
⁷ Contilia Heart- and Vascular Center, Clinic for Cardiology, Elisabeth Hospital Essen, Germany.
⁸ Department for Thoracic Surgery, Kerckhoff Clinic, Bad Nauheim, Germany.
⁹ Clinic of Pneumology, University Hospital Zurich, Switzerland.
¹⁰ IRCCS S.D.N. Institute, Neapel, Italy.
¹¹ Department of Internal Medicine, Pulmonology and Critical Care Medicine, Thorax Clinic at the University Hospital Heidelberg, Heidelberg, Germany; Lung Centre, Clinic Mittelbaden, Baden-Baden Balg, Baden-Baden, Germany.
¹² Clinic for Anesthesiology, Critical Care, Pain Therapy and Palliative Care, St. Georg Hospital Leipzig, Germany.
¹³ Department of Respiratory Medicine, University of Leipzig, Leipzig, Germany.
¹⁴ Pediatric Heart Center, Justus-Liebig University, Giessen, Germany.
¹⁵ Department of Respiratory Medicine, Hannover Medical School, Hannover, Germany, German Centre for Lung Research (DZL), Germany.
¹⁶ Division of Pneumology, Department of Internal Medicine II, University Medical Center Regensburg, Regensburg, Germany.

PMID: 30190155
DOI: 10.1016/j.ijcard.2018.08.081

Abstract

In June 2016, members of the German Society of Cardiology (DGK), the German Society of Respiratory Medicine (DGP) and the German Society of Pediatric Cardiology (DGPK) met for a Consensus Conference in Cologne, Germany. Aim of this Conference was to compile consensus based practice recommendations based on the 2015 European Pulmonary Hypertension guidelines, aiming at their practical implementation, considering country-specific issues, and including new evidence, where available. This article summarizes the results and updated recommendations 2018 of the working group on decompensated right heart failure (RHF), intensive care and perioperative management in patients with pulmonary hypertension. The RHF section comprises definition and pathophysiology, diagnosis and monitoring, identification of triggering factors and supportive therapy of RHF, volume management as well as PAH targeting therapy, therapy with inotropic, inodilator and vasopressor drugs, extracorporeal support and transplantation. The second part of this article summarizes preoperative management, perioperative monitoring and choice of anesthesia.

Keywords: Decompensation; Intensive care; Perioperative management; Pulmonary hypertension; Right heart failure.

Publication types

Review

MeSH terms

Consensus Development Conferences as Topic*
Critical Care / methods*
Disease Management
Germany / epidemiology
Heart Failure / diagnosis
Heart Failure / epidemiology
Heart Failure / therapy*
Humans
Hypertension, Pulmonary / diagnosis
Hypertension, Pulmonary / epidemiology
Hypertension, Pulmonary / therapy*
Perioperative Care / methods*
Practice Guidelines as Topic / standards*
Randomized Controlled Trials as Topic / methods
Randomized Controlled Trials as Topic / standards