These guidelines provide evidence-based recommendations for the diagnosis and intensive care management of critically ill patients with pulmonary hypertension, emphasizing individualized therapy and RV failure management.
Emphasizes right ventricular failure treatment in pulmonary hypertension; extends international guidelines to Saudi critical care practice.
Pulmonary hypertension (PH) in the Intensive Care Unit (ICU) may be due to preexisting pulmonary vascular lung disease, liver disease, or cardiac diseases. PH also may be caused by critical illnesses, such as acute respiratory distress syndrome (ARDS), acute left ventricular dysfunction and pulmonary embolism, or may occur after cardiac or thoracic surgery. Regardless of the underlying cause of PH, the final common pathway for hemodynamic deterioration and death is RV failure, which is the most challenging aspect of patient management. Therapy is thus aimed at acutely relieving RV overload by decreasing PVR and reversing RV failure with pulmonary vasodilators and inotropes.
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Al‐Azem et al. (2014) conducted a review in Pulmonary hypertension in the intensive care unit. Intensive care management was evaluated. The Saudi guidelines recommend echocardiography for screening and right heart catheterization for confirmation of pulmonary hypertension in critically ill patients, followed by individualized therapy.
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