Cardiology
Right ventricular failure & pulmonary hypertension
Right ventricular (RV) failure and pulmonary hypertension (PH) are critical conditions that often complicate cardiac, pulmonary, and critical care scenarios. Both conditions are associated with high morbidity and mortality in ICU patients, requiring early recognition, targeted interventions, and specialized management strategies.
This section covers:
- Pulmonary hypertension, with ESC/ERS guidelines detailing diagnostic work-up, classification, and therapeutic strategies relevant to ICU professionals.
- Acute right ventricular failure, highlighting evidence-based management approaches including pharmacologic support, mechanical interventions, and the role of extracorporeal life support (ECMO).
By integrating hemodynamic assessment, echocardiography, and tailored treatment strategies, clinicians can optimize right heart function and improve outcomes in critically ill patients with RV failure and pulmonary hypertension.
Pulmonary hypertension
Pulmonary hypertension
2022 ESC/ERS Guidelines for the diagnosis and treatment of pulmonary hypertension
Marc Humbert et al., European Heart Journal (2022)
What’s inside
This article presents the 2022 ESC/ERS guidelines for diagnosing and treating pulmonary hypertension. Not all sections are directly relevant to ICU professionals. Start by reading Chapter 3 (general introduction), Chapter 5.1 (diagnostic approach), and Chapter 6 (general treatment overview). Key messages can be found in Chapter 13, with practical recommendations in Chapter 15 (do’s and don’ts).
Why it’s relevant
Pulmonary hypertension is a critical condition in ICU settings, particularly in patients with cardiac or pulmonary comorbidities. Early recognition and management are essential for improving outcomes. The guidelines offer practical insights, especially for diagnostic and treatment approaches in critically ill patients.
Key focus
- Classification and diagnostic work-up of pulmonary hypertension, including imaging and hemodynamic assessments
- General treatment strategies, including pharmacologic options and management of right heart failure
- Practical recommendations and “do’s and don’ts” for ICU professionals
Takeaway
The 2022 ESC/ERS guidelines provide vital information for ICU professionals managing pulmonary hypertension. Focus on the diagnostic approach, general treatment overview, and key messages to guide care in critically ill patients.
Right ventricular failure
Right ventricular failure
Contemporary management of acute right ventricular failure: a statement from the Heart Failure Association and the Working Group on Pulmonary Circulation and Right Ventricular Function of the European Society of Cardiology
Veli-Pekka Harjola et al., European Journal of Heart Failure (2016)
What’s inside
This article discusses the contemporary management of acute right ventricular (RV) failure, a condition often seen in critically ill patients. The statement highlights evidence-based strategies for diagnosing and treating acute RV failure, with a focus on pharmacologic and mechanical support..
Why it’s relevant
Acute right ventricular failure is a life-threatening condition frequently encountered in the ICU, particularly in patients with pulmonary embolism, cardiogenic shock, or after major surgery. Prompt diagnosis and treatment are essential to improving survival. This statement provides critical insights for managing RV failure in the ICU setting.
Key focus
- Diagnostic approach to acute RV failure, including clinical signs, imaging, and biomarkers
- Acute management strategies: pharmacologic therapy, inotropes, vasopressors, and mechanical support
- Role of extracorporeal membrane oxygenation (ECMO) and other advanced therapies
- Multidisciplinary approach for optimizing patient outcomes
Takeaway
This statement offers valuable guidance for ICU professionals managing acute right ventricular failure. Focus on the diagnostic approach and acute management strategies, particularly pharmacologic and mechanical support options, to improve patient survival.