title: Severe pulmonary arterial hypertension: stratification of medical therapies, mechanical support, and lung transplantation.
abstract: Severe pulmonary hypertension is recognized by focusing on the clinical signs and tests that demonstrate decompensated right ventricular failure or, in the worst-case scenario, shock. An aggressive treatment regimen including a prostacyclin infusion is required for these patients. Once admitted to the hospital, or the ICU for decompensated right ventricular failure, the short- and long-term outcomes for PAH patients are poor. For those who are candidates, urgent lung transplantation, or extracorporeal membrane oxygenation (ECMO) as a bridge to lung transplantation may be rescue therapy.
authors.affiliation: Pulmonary and Critical Care Medicine, UT Southwestern Medical Center, 5323 Harry Hines Blvd, Rm HQ1.200, Dallas, TX, 75390-8550, USA. Sonja.Bartolome@UTSouthwestern.edu.
authors.forename: Sonja Darrell
authors.initials: SD
authors.lastname: Bartolome
authors.affiliation: Pulmonary and Critical Care Medicine, UT Southwestern Medical Center, 5323 Harry Hines Blvd, Rm HQ1.200, Dallas, TX, 75390-8550, USA.
authors.forename: Fernando
authors.initials: F
authors.lastname: Torres
mesh_terms: D000208:Acute Disease; D000959:Antihypertensive Agents / Q000627:therapeutic use; D002302:Cardiac Output; D019468:Disease Management; D004452:Echocardiography; D015199:Extracorporeal Membrane Oxygenation; D006333:Heart Failure / Q000628:therapy*; D006801:Humans; D006976:Hypertension, Pulmonary / Q000150:complications* / Q000000981:diagnostic imaging / Q000628:therapy*; D007362:Intensive Care Units; D016040:Lung Transplantation; D008279:Magnetic Resonance Imaging; D018497:Ventricular Dysfunction, Right / Q000628:therapy*
chemical_list: D000959:Antihypertensive Agents
keywords: Acute right ventricular failure; ECMO; Lung transplantation; Pulmonary arterial hypertension