title: Management of right heart failure in the critically ill.
abstract: Right ventricular failure complicates several commonly encountered conditions in the intensive care unit. Right ventricular dilation and paradoxic movement of the interventricular septum on echocardiography establishes the diagnosis. Right heart catheterization is useful in establishing the specific cause and aids clinicians in management. Principles of treatment focus on reversal of the underlying cause, optimization of right ventricular preload and contractility, and reduction of right ventricular afterload. Mechanical support with right ventricular assist device or veno-arterial extracorporeal membrane oxygenation can be used in select patients who fail to improve with optimal medical therapy.
authors.affiliation: Medical Critical Care Service, Inova Fairfax Hospital, 618 South Royal Street, Alexandria, VA 22314, USA. Electronic address: Csking123@hotmail.com.
authors.forename: Christopher
authors.initials: C
authors.lastname: King
authors.affiliation: Advanced Heart Failure and Cardiac Transplant Program, Inova Fairfax Hospital, 3300 Gallows Road, Falls Church, VA 22042, USA.
authors.forename: Christopher W
authors.initials: CW
authors.lastname: May
authors.affiliation: Medical Critical Care Service, Inova Fairfax Hospital, 3300 Gallows Road, Falls Church, VA 22042, USA.
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Williams
authors.affiliation: Advanced Lung Disease and Transplant Program, Inova Fairfax Hospital, 3300 Gallows Road, Falls Church, VA 22042, USA.
authors.forename: Oksana A
authors.initials: OA
authors.lastname: Shlobin
mesh_terms: D003422:Critical Care / Q000379:methods*; D016638:Critical Illness / Q000628:therapy*; D006333:Heart Failure / Q000150:complications / Q000175:diagnosis* / Q000628:therapy*; D006801:Humans; D006976:Hypertension, Pulmonary / Q000150:complications / Q000175:diagnosis / Q000628:therapy; D017410:Practice Guidelines as Topic; D012128:Respiratory Distress Syndrome / Q000150:complications / Q000175:diagnosis / Q000628:therapy; D018497:Ventricular Dysfunction, Right / Q000150:complications / Q000175:diagnosis* / Q000628:therapy*
keywords: Acute respiratory distress syndrome; Pulmonary hypertension; Right ventricular dysfunction; Right ventricular failure