What role does the right side of the heart play in circulation?
Right ventricular failure (RVF) is an underestimated problem in intensive care. This review explores the physiology and pathophysiology of right ventricular function and the pulmonary circulation. When RVF is secondary to an acute increase in afterload, the picture is one of acute cor pulmonale, as occurs in the context of acute respiratory distress syndrome, pulmonary embolism and sepsis. RVF can also be caused by right myocardial dysfunction. Pulmonary arterial catheterization and echocardiography are discussed in terms of their roles in diagnosis and treatment. Treatments include options to reduce right ventricular afterload, specific pulmonary vasodilators and inotropes.
Cecconi
Maurizio
M
Department of Intensive Care, St, George's Hospital, London, UK.
Johnston
Edward
E
Rhodes
Andrew
A
D002316:Cardiotonic Agents / Q000627:therapeutic use; D002407:Catheterization, Swan-Ganz / Q000379:methods; D003422:Critical Care / Q000379:methods; D004452:Echocardiography; D005440:Fluid Therapy; D006333:Heart Failure / Q000150:complications; D006801:Humans; D007040:Hypoventilation / Q000150:complications / Q000503:physiopathology; D009203:Myocardial Infarction / Q000150:complications / Q000628:therapy; D011652:Pulmonary Circulation / Q000502:physiology; D011655:Pulmonary Embolism / Q000150:complications / Q000503:physiopathology; D012121:Respiration, Artificial / Q000379:methods; D012128:Respiratory Distress Syndrome / Q000150:complications / Q000503:physiopathology; D018805:Sepsis / Q000150:complications; D014662:Vasoconstrictor Agents / Q000627:therapeutic use; D014665:Vasodilator Agents / Q000627:therapeutic use; D018497:Ventricular Dysfunction, Right / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology* / Q000628:therapy; D016278:Ventricular Function, Right / Q000502:physiology*
D002316:Cardiotonic Agents; D014662:Vasoconstrictor Agents; D014665:Vasodilator Agents