Pulmonary hypertension and its management in patients undergoing non-cardiac surgery

Anaesthesia. 2015 Jan;70(1):56-70. doi: 10.1111/anae.12831. Epub 2014 Sep 29.

Abstract

Pulmonary hypertension is a complex disorder of the pulmonary vasculature that leads to increased peri-operative morbidity and mortality. Non-cardiac surgery constitutes a significant risk in patients with pulmonary hypertension. The management of right ventricular failure is inherently challenging and fraught with life-threatening consequences. A thorough understanding of the pathophysiology, the severity of the disease and its treatment modalities is required to deliver optimal peri-operative care. This review provides an evidence-based overview of the definition, classification, pathophysiology, diagnosis and treatment of pulmonary hypertension and focuses on the peri-operative management and treatment of pulmonary hypertensive crises in a non-cardiac setting.

Publication types

  • Review

MeSH terms

  • Anesthesia, General / methods
  • Antihypertensive Agents / therapeutic use
  • Cardiac Surgical Procedures
  • Evidence-Based Medicine / methods
  • Humans
  • Hypertension, Pulmonary / diagnosis
  • Hypertension, Pulmonary / drug therapy*
  • Hypertension, Pulmonary / physiopathology
  • Perioperative Care / methods*
  • Risk Assessment / methods
  • Surgical Procedures, Operative*
  • Terminology as Topic

Substances

  • Antihypertensive Agents