The Internet Book of Critical Care Podcast IBCC Episode 95 - Inhaled Pulmonary Vasodilators
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Aug 8, 2020 AI Snips
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Purpose of Inhaled Pulmonary Vasodilators
- Inhaled pulmonary vasodilators improve oxygenation by enhancing ventilation-perfusion matching.
- They preferentially dilate vessels in well-ventilated alveoli, directing blood flow to better oxygenated areas.
Manage Right-To-Left Shunt Carefully
- In patients with elevated right heart pressures and patent foramen ovale, inhaled vasodilators can reduce right-to-left shunt and improve oxygenation.
- Avoid excessive PEEP or tidal volumes as they can worsen shunting by increasing pulmonary vascular resistance.
Choosing Pulmonary Vasodilators
- No pulmonary vasodilator drug is proven superior in effectiveness; choice often depends on logistics and availability.
- Nitroglycerine and milrinone are quickest to obtain; nitric oxide and epoprostenol allow easier titration.