Pulmonary Hypertension Flashcards
1
Q
Causes of Pulmonary HTN:
A
1- Idiopathic
2- Lung
- Chronic hypoxia
- Cor pulmonale
3- Left heart
–> Valvular
–> LV failure
4- Pulmonary vessels
–> PE
–> Vasculitis etc.
2
Q
Principles of managing pulmonary hypertension:
A
REDUCE PVR
- Optimise oxygenation
- Avoid hypercarbia
- Nitric oxide
SUPPORT PRELOAD
- Maintain sinus rhythm and rate
- Fluid / diuresis (dep on volume state)
- Avoid nitrates/ vasodilaators
SUPPORT RV INOTROPY
- Optimise elecs, pH
- Rhythm and rate control
- DOBUTAMINE is inotrope of choice
- Keep MAP up (no perfusion if PVR>SVR)
—–> Norad or vasopressin
