Pulmonary Hypertension Spotlight-Crashing Pulmonary Hypertension Patient in ICU

Video Transcription

Video Summary

In this video, three physicians discuss the management of pulmonary hypertension (PH) in various clinical scenarios. The first speaker, Bhavin Dalal, discusses the perioperative and preoperative assessment of PH patients who need surgery. He emphasizes the importance of treating the underlying cause of PH, optimizing RV function, and managing the surrounding environment, such as arrhythmias, mechanical ventilation, and volume shifts. Dalal also highlights the need for a multidisciplinary team approach and risk stratification of PH patients. He concludes by recommending continued PH medication during the perioperative period and considering the use of inhaled agents for induction.<br /><br />The second speaker, Steve Mathai, focuses on the management of PH in the ICU, particularly in acute settings. He emphasizes the need to optimize preload, reduce afterload, and optimize contractility of the right ventricle. Mathai discusses the importance of treating atrial arrhythmias in PH patients and the potential role of different medications, such as amiodarone and digoxin. He also highlights the impact of mechanical ventilation on pulmonary vascular resistance and the importance of maintaining normal blood pressure and oxygenation. Mathai concludes by stressing the high mortality rate of PH patients in the ICU and the need for a multifaceted approach to management.<br /><br />The third speaker, Sandeep Sahay, discusses the pharmacological management of RV failure in PH patients in the ICU. He talks about the importance of treating the cause of RV failure, optimizing RV function, and improving the surrounding environment. Sahay highlights the use of medications such as milrinone, dobutamine, and epinephrine to improve RV contractility and reduce afterload. He also emphasizes the need for close hemodynamic monitoring and individualized care for PH patients in the ICU.<br /><br />Overall, the speakers provide valuable insights into the management of PH in different clinical settings, stressing the importance of individualized care and a multidisciplinary approach.

Meta Tag

Category Pulmonary Vascular Disease

Speaker Stephen Mathai, MD, MHS, FCCP

Speaker Sandeep Sahay, MD, FCCP

Speaker Jean Elwing, MD, FCCP

Speaker Bhavinkumar Dalal, MD, FCCP

Keywords

pulmonary hypertension

management

perioperative assessment

RV function

multidisciplinary approach

ICU management

atrial arrhythmias

mechanical ventilation

blood pressure

individualized care

PH