Why Systemic Pulmonary Vasodilators Are Avoided in COPD Patients with Pulmonary Hypertension

In patients with COPD and pulmonary hypertension, avoiding systemic pulmonary vasodilators is crucial due to the risk of worsening VQ matching and hypoxemia. While lowering pulmonary artery pressures may seem beneficial, systemic administration can lead to oxygen levels dropping despite the pressure decrease. Inhaled pulmonary vasodilators offer a safer alternative by selectively targeting well-ventilated lung areas, preventing increased perfusion to poorly ventilated regions.