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.

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