Key result
Integrated assessment of physiology and right heart function guides ICU management of PH and RVF.
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Design
Review
May inform tailored ICU therapy for pulmonary hypertension and right ventricular failure; leaves open validation through randomized trials.
Pulmonary hypertension (PH) encompasses a broad range of conditions, including pulmonary artery hypertension, left-sided heart disease, and pulmonary and thromboembolic disorders. Successful diagnosis and management rely on an integrated clinical assessment of the patient's physiology and right heart function. Right ventricular (RV) heart failure is often a result of PH, but may result from varying abnormalities in preload, afterload, and intrinsic myocardial dysfunction, which require distinct management strategies. Consideration of an individual's hemodynamic phenotype and physiologic circumstances is paramount in management of PH and RV failure, particularly when there is clinical instability in the intensive care setting.
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Vaidy et al. (2023) studied this question. Integrated clinical assessment of physiology and right heart function is crucial for managing pulmonary hypertension and right ventricular failure in the ICU.
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