Critical Care Scenarios Episode 54: The critically ill patient with pulmonary hypertension, with Ray Foley
14 snips
Dec 7, 2022 AI Snips
Chapters
Transcript
Episode notes
Right Ventricle Beats Pressure Numbers
- Focus on RV size, function, TAPSE, septal motion and pericardial effusion rather than just pressure estimates.
- Compare prior outpatient echo with an immediate bedside echo to judge acute risk.
Etiology Changes Risk Profile
- Etiology matters: group 1 (PAH) and group 4 (CTEPH) patients often carry higher risk than mild group 3 disease.
- Use the PH group to set acuity expectations and escalation plans.
Keep PAH Therapy Unless Delivery Fails
- Continue PAH‑specific outpatient therapies in hospital unless delivery or absorption is doubtful.
- If oral absorption is uncertain, transition early to parenteral or inhaled alternatives.