Multiprofessional Critical Care Review: Adult 2024 (MCCRCA24ON)-7: Pulmonary Hypertension in Critical Illness: the "Right" Management (Lee Goeddel, MD)

7: Pulmonary Hypertension in Critical Illness: the "Right" Management (Lee Goeddel, MD)

Video Transcription

Video Summary

The video discusses the management of pulmonary hypertension in critical illness, focusing on right ventricular function. The speaker presents a mental model of six topics to address when managing pulmonary hypertension: preload optimization, reducing RV afterload, treating causes of RV failure, supporting RV contractility, maintaining perfusion pressure, and considering mechanical circulatory support if necessary. The speaker emphasizes the importance of ventricular interdependence and discusses the physiology of the right ventricle under increased pressure. They also cover the classification of pulmonary hypertension causes and the anatomy and mechanics of the right ventricle. The video emphasizes the need to identify and manage underlying causes of RV failure, optimize preload and volume, support RV contractility, and reduce RV afterload. The use of inotropic therapy, pulmonary vasodilators, and mechanical support is also discussed. The speaker concludes by highlighting the importance of early diagnosis and treatment to prevent decompensation in patients with pulmonary hypertension.

Keywords

pulmonary hypertension

critical illness

right ventricular function

preload optimization

RV afterload

RV failure

RV contractility

mechanical circulatory support

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