Management of Sepsis in Patients with Pulmonary Arterial Hypertension in the Intensive Care Unit.
Pulmonary arterial hypertension is a lethal condition, and the management of sepsis in patients with pulmonary arterial hypertension is challenging. As the disease progresses, the right ventricle is susceptible to failure due to a high pulmonary vascular resistance. The limited ability of the right ventricle to increase cardiac output in septic shock makes it difficult to deliver oxygen to the organ and tissues. Intravascular volume replacement and vasoactive drugs should only be considered after a thorough assessment. Priorities of care include improving cardiac output and oxygen delivery by optimizing preload, reducing afterload, and improving contractility.
School of Nursing, Louisiana State University Health Sciences Center, 1900 Gravier Street, New Orleans, LA 70112, USA. Electronic address: TTARTA@LSUHSC.EDU.
Todd M
TM
Tartavoulle
D002302:Cardiac Output; D006333:Heart Failure; D006801:Humans; D006976:Hypertension, Pulmonary / Q000150:complications* / Q000628:therapy; D007362:Intensive Care Units; D018805:Sepsis / Q000628:therapy*; D018497:Ventricular Dysfunction, Right / Q000150:complications* / Q000628:therapy
Cardiac output; Pulmonary arterial hypertension; Right ventricular failure; Sepsis