Tasty Morsels of Critical Care Tasty Morsels of Critical Care 081 | Pulmonary Hypertension ICU management strategies
May 27, 2024
Delving into the world of pulmonary hypertension management in critically ill patients, the podcast highlights the importance of continuing PH specific meds, the focus on treating PVR over PA pressures, and the challenges of maintaining right-to-left heart flow. The discussion offers practical insights for navigating these complexities in the ICU setting.
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Managing PH Meds Post-Op
- Continue chronic pulmonary hypertension medications even post-op.
- These medications, especially continuous infusions like epoprostenol, are crucial for managing PVR.
Prioritize PVR over PA Pressures
- Focus on treating pulmonary vascular resistance (PVR), not just PA pressures.
- While PA pressures are important, PVR is the key factor determining right-to-left heart flow and, ultimately, patient outcomes.
Vasopressor Selection in PH
- Consider vasopressors carefully; vasopressin may increase PVR less than norepinephrine.
- Milrinone, while easy on PVR, can dramatically drop SVR, impacting right ventricle perfusion.