Why the study?
Does gradually increasing blood flow into the lungs improve acute severe pulmonary hypertension during weaning from cardiopulmonary bypass?
Does gradually increasing blood flow into the lungs improve acute severe pulmonary hypertension during weaning from cardiopulmonary bypass?
Gradually increasing blood flow into the lungs may be a viable approach for managing acute, severe pulmonary hypertension after cardiopulmonary bypass without requiring mechanical circulatory support.
Pulmonary arterial pressure (PAH) usually increases after cardiopulmonary bypass (CPB), but this normally does not affect weaning off CPB. Here we report a case of severe PAH in a patient with normal left atrial pressure. Prolonging CPB by 45 min did not lead to lower PAH. Given that lung injury can stimulate secretion of vasoconstrictors that trigger PAH, we decided to gradually increase blood flow into the lungs in an effort to restore the balance between pulmonary vasoconstrictors and vasodilators. Pulmonary artery pressure gradually decreased, allowing the patient to be weaned off CPB, after which she recovered uneventfully. Our experience suggests an approach for managing acute, severe PAH after CPB without the need for mechanical circulatory support.
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Xiong et al. (2023) studied this question.
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