Pulmonary hypertension in the critical care setting: classification, pathophysiology, diagnosis, and management.
Pulmonary hypertension (PH) is common in the critical care setting, and may be a target for specific therapy. Moderate degrees of pulmonary hypertension are most often the consequence of acute or chronic heart failure, hypoxemia, or acute pulmonary embolism, and may be relatively rapidly reversible. The consequences of more severe forms of PH, both acute and chronic, can include hypotension; low cardiac output; right heart failure with congestion of the liver, gut, and kidneys; and varying degrees of hypoxemia, each of which can lead to death or severe disability. We review the physiology, definitions, classification, pathogenesis, diagnostic tools, and algorithms for diagnosis and specific treatments for the various causes of PH as seen in the critical care setting.
Rubenfire
Melvyn
M
Division of Cardiovascular Medicine and Department of Internal Medicine, University of Michigan, Ann Arbor, MI 48106-0363, USA. mrubenfi@umich.edu
Bayram
Melike
M
Hector-Word
Zachary
Z
D000208:Acute Disease; D000465:Algorithms; D002317:Cardiovascular Agents / Q000494:pharmacology / Q000627:therapeutic use; D002908:Chronic Disease; D003422:Critical Care; D006801:Humans; D006976:Hypertension, Pulmonary / Q000145:classification / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D013923:Thromboembolism / Q000150:complications
D002317:Cardiovascular Agents