The Curious Clinicians
88 - Shunting a Mismatch
May 1, 2024
Medical student Giancarlo Buonomo joins the podcast to discuss the complexities of systemic pulmonary vasodilators in COPD patients with pulmonary hypertension. The episode explores the impact of sildenafil, inhaled vasodilators, and supplemental oxygen therapy on blood oxygen levels and vascular functions in lung diseases.
23:02
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Quick takeaways
- Systemic pulmonary vasodilators can worsen hypoxemia in COPD-associated pulmonary hypertension by disrupting VQ matching.
- Inhaled vasodilators like nitric oxide offer a safer and effective alternative for treating COPD-associated pulmonary hypertension.
Deep dives
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.
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