The role of nitric oxide and vasopressin in refractory right heart failure.
The standard treatment for right heart failure includes aggressive fluid resuscitation, inotropic agents, and avoiding drugs, such as diuretics or nitrates, or maneuvers that decrease pre-load. Even an increase in vagal tone caused by the insertion of a bladder catheter can acutely decrease preload and lead to cardiogenic shock. Other modalities include early reperfusion therapy and pacemaker implantation for complete heart block or loss of atrioventricular synchrony. Acute right heart failure carries a very high mortality because of the limited options available for its management. Among newer treatments, inhaled nitric oxide and intravenous vasopressin have shown promise for acute right ventricular failure.
Wasson
Sanjeev
S
Department of Internal Medicine, University of Missouri at Columbia, MA 406, One Hospital Drive, Columbia, MO 65212, USA.
Govindarajan
Gurushankar
G
Reddy
H K
HK
Flaker
Gregory
G
D000280:Administration, Inhalation; D005260:Female; D016166:Free Radical Scavengers / Q000008:administration & dosage / Q000627:therapeutic use*; D006333:Heart Failure / Q000209:etiology*; D006801:Humans; D008875:Middle Aged; D009569:Nitric Oxide / Q000008:administration & dosage / Q000627:therapeutic use*; D012008:Recurrence; D014662:Vasoconstrictor Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D014667:Vasopressins / Q000008:administration & dosage / Q000627:therapeutic use*; D018497:Ventricular Dysfunction, Right / Q000150:complications / Q000188:drug therapy*
D016166:Free Radical Scavengers; D014662:Vasoconstrictor Agents; D014667:Vasopressins; D009569:Nitric Oxide