Skip to main content
Erschienen in: Current Heart Failure Reports 3/2012

01.09.2012 | Decompensated Heart Failure (MM Givertz, Section editor)

Management of Acute Right Ventricular Failure in the Intensive Care Unit

verfasst von: Eric M. Green, Michael M. Givertz

Erschienen in: Current Heart Failure Reports | Ausgabe 3/2012

Einloggen, um Zugang zu erhalten

Abstract

Acute failure of the right ventricle is a common challenge in the intensive care unit that is associated with significant morbidity and mortality. Although often a complication of left ventricular failure, right ventricular failure is a distinct clinical entity, both in terms of its hemodynamic abnormalities and response to treatment. Effective management of right ventricular failure must consider the unique properties of the right ventricle and the pulmonary circulation, and their response to common pharmacologic and mechanical interventions. In this review, we present a contemporary approach to patients with acute failure of the right ventricle including strategies for mechanical ventilation, hemodynamic management, and mechanical circulatory support.
Literatur
1.
Zurück zum Zitat Kagan A. Dynamic responses of the right ventricle following extensive damage by cauterization. Circulation. 1952;5(6):816–23.PubMedCrossRef Kagan A. Dynamic responses of the right ventricle following extensive damage by cauterization. Circulation. 1952;5(6):816–23.PubMedCrossRef
2.
Zurück zum Zitat Mehta SR, Eikelboom JW, Natarajan MK, Diaz R, Yi C, Gibbons RJ, et al. Impact of right ventricular involvement on mortality and morbidity in patients with inferior myocardial infarction. J Am Coll Cardiol. 2001;37(1):37–43.PubMedCrossRef Mehta SR, Eikelboom JW, Natarajan MK, Diaz R, Yi C, Gibbons RJ, et al. Impact of right ventricular involvement on mortality and morbidity in patients with inferior myocardial infarction. J Am Coll Cardiol. 2001;37(1):37–43.PubMedCrossRef
3.
Zurück zum Zitat Goldstein JA, Harada A, Yagi Y, Barzilai B, Cox JL. Hemodynamic importance of systolic ventricular interaction, augmented right atrial contractility and atrioventricular synchrony in acute right ventricular dysfunction. J Am Coll Cardiol. 1990;16(1):181–9.PubMedCrossRef Goldstein JA, Harada A, Yagi Y, Barzilai B, Cox JL. Hemodynamic importance of systolic ventricular interaction, augmented right atrial contractility and atrioventricular synchrony in acute right ventricular dysfunction. J Am Coll Cardiol. 1990;16(1):181–9.PubMedCrossRef
4.
Zurück zum Zitat ••Maeder MT, Holst DP, Kaye DM. Tricuspid regurgitation contributes to renal dysfunction in patients with heart failure. J Card Fail. 2008;14(10):824–30. Elsevier. Renal dysfunction is a frequent complication of heart failure and is thought to result from decreased renal perfusion and low cardiac output. This paper suggests a role for right ventricular failure and venous congestion, specifically tricuspid regurgitation, in renal dysfunction.PubMedCrossRef ••Maeder MT, Holst DP, Kaye DM. Tricuspid regurgitation contributes to renal dysfunction in patients with heart failure. J Card Fail. 2008;14(10):824–30. Elsevier. Renal dysfunction is a frequent complication of heart failure and is thought to result from decreased renal perfusion and low cardiac output. This paper suggests a role for right ventricular failure and venous congestion, specifically tricuspid regurgitation, in renal dysfunction.PubMedCrossRef
5.
Zurück zum Zitat Stein PD, Sabbah HN, Anbe DT, Marzilli M. Performance of the failing and nonfailing right ventricle of patients with pulmonary hypertension. Am J Cardiol. 1979;44(6):1050–5.PubMedCrossRef Stein PD, Sabbah HN, Anbe DT, Marzilli M. Performance of the failing and nonfailing right ventricle of patients with pulmonary hypertension. Am J Cardiol. 1979;44(6):1050–5.PubMedCrossRef
6.
Zurück zum Zitat McIntyre KM, Sasahara AA. The hemodynamic response to pulmonary embolism in patients without prior cardiopulmonary disease. Am J Cardiol. 1971;28(3):288–94.PubMedCrossRef McIntyre KM, Sasahara AA. The hemodynamic response to pulmonary embolism in patients without prior cardiopulmonary disease. Am J Cardiol. 1971;28(3):288–94.PubMedCrossRef
7.
Zurück zum Zitat O’Rourke RA, Dell’Italia LJ. Diagnosis and management of right ventricular myocardial infarction. Curr Probl Cardiol. 2004;29(1):6–47.PubMedCrossRef O’Rourke RA, Dell’Italia LJ. Diagnosis and management of right ventricular myocardial infarction. Curr Probl Cardiol. 2004;29(1):6–47.PubMedCrossRef
8.
Zurück zum Zitat Lahm T, McCaslin CA, Wozniak TC, Ghumman W, Fadl YY, Obeidat OS, et al. Medical and surgical treatment of acute right ventricular failure. J Am Coll Cardiol. 2010;56(18):1435–46.PubMedCrossRef Lahm T, McCaslin CA, Wozniak TC, Ghumman W, Fadl YY, Obeidat OS, et al. Medical and surgical treatment of acute right ventricular failure. J Am Coll Cardiol. 2010;56(18):1435–46.PubMedCrossRef
9.
Zurück zum Zitat Haddad F, Hunt SA, Rosenthal DN, Murphy DJ. Right ventricular function in cardiovascular disease, part I: anatomy, physiology, aging, and functional assessment of the right ventricle. Circulation. 2008;117(11):1436–48.PubMedCrossRef Haddad F, Hunt SA, Rosenthal DN, Murphy DJ. Right ventricular function in cardiovascular disease, part I: anatomy, physiology, aging, and functional assessment of the right ventricle. Circulation. 2008;117(11):1436–48.PubMedCrossRef
10.
Zurück zum Zitat Balanos GM, Talbot NP, Dorrington KL, Robbins PA. Human pulmonary vascular response to 4 h of hypercapnia and hypocapnia measured using Doppler echocardiography. J Appl Physiol. 2003;94(4):1543–51.PubMed Balanos GM, Talbot NP, Dorrington KL, Robbins PA. Human pulmonary vascular response to 4 h of hypercapnia and hypocapnia measured using Doppler echocardiography. J Appl Physiol. 2003;94(4):1543–51.PubMed
11.
Zurück zum Zitat Vieillard-Baron A, Jardin F. Why protect the right ventricle in patients with acute respiratory distress syndrome? Curr Opin Crit Care. 2003;9(1):15–21.PubMedCrossRef Vieillard-Baron A, Jardin F. Why protect the right ventricle in patients with acute respiratory distress syndrome? Curr Opin Crit Care. 2003;9(1):15–21.PubMedCrossRef
12.
Zurück zum Zitat Jardin F, Vieillard-Baron A. Right ventricular function and positive pressure ventilation in clinical practice: from hemodynamic subsets to respirator settings. Intensive Care Med. 2003;29(9):1426–34.PubMedCrossRef Jardin F, Vieillard-Baron A. Right ventricular function and positive pressure ventilation in clinical practice: from hemodynamic subsets to respirator settings. Intensive Care Med. 2003;29(9):1426–34.PubMedCrossRef
13.
Zurück zum Zitat David M, von Bardeleben RS, Weiler N, Markstaller K, Scholz A, Karmrodt J, et al. Cardiac function and haemodynamics during transition to high-frequency oscillatory ventilation. Eur J Anaesthesiol. 2004;21(12):944–52.PubMed David M, von Bardeleben RS, Weiler N, Markstaller K, Scholz A, Karmrodt J, et al. Cardiac function and haemodynamics during transition to high-frequency oscillatory ventilation. Eur J Anaesthesiol. 2004;21(12):944–52.PubMed
14.
Zurück zum Zitat Vieillard-Baron A, Charron C, Caille V, Belliard G, Page B, Jardin F. Prone positioning unloads the right ventricle in severe ARDS. Chest. 2007;132(5):1440–6.PubMedCrossRef Vieillard-Baron A, Charron C, Caille V, Belliard G, Page B, Jardin F. Prone positioning unloads the right ventricle in severe ARDS. Chest. 2007;132(5):1440–6.PubMedCrossRef
15.
Zurück zum Zitat Sarnoff SJ. Myocardial contractility as described by ventricular function curves; observations on Starling’s law of the heart. Physiol Rev. 1955;35(1):107–22.PubMed Sarnoff SJ. Myocardial contractility as described by ventricular function curves; observations on Starling’s law of the heart. Physiol Rev. 1955;35(1):107–22.PubMed
16.
Zurück zum Zitat Cohn JN, Guiha NH, Broder MI, Limas CJ. Right ventricular infarction. Clinical and hemodynamic features. Am J Cardiol. 1974;33(2):209–14.PubMedCrossRef Cohn JN, Guiha NH, Broder MI, Limas CJ. Right ventricular infarction. Clinical and hemodynamic features. Am J Cardiol. 1974;33(2):209–14.PubMedCrossRef
17.
Zurück zum Zitat Schneider A, Teule G, Groeneveld A. ScienceDirect.com - American Heart Journal - Biventricular performance during volume loading in patients with early septic shock, with emphasis on the right ventricle: a combined hemodynamic and radionuclide study. Am Heart J. 1988;116(1):103–12.PubMedCrossRef Schneider A, Teule G, Groeneveld A. ScienceDirect.com - American Heart Journal - Biventricular performance during volume loading in patients with early septic shock, with emphasis on the right ventricle: a combined hemodynamic and radionuclide study. Am Heart J. 1988;116(1):103–12.PubMedCrossRef
18.
Zurück zum Zitat Piazza G, Goldhaber SZ. The acutely decompensated right ventricle: pathways for diagnosis and management. Chest. 2005;128(3):1836–52.PubMedCrossRef Piazza G, Goldhaber SZ. The acutely decompensated right ventricle: pathways for diagnosis and management. Chest. 2005;128(3):1836–52.PubMedCrossRef
19.
Zurück zum Zitat Ferrario M, Poli A, Previtali M, Lanzarini L, Fetiveau R, Diotallevi P, et al. Hemodynamics of volume loading compared with dobutamine in severe right ventricular infarction. Am J Cardiol. 1994;74(4):329–33.PubMedCrossRef Ferrario M, Poli A, Previtali M, Lanzarini L, Fetiveau R, Diotallevi P, et al. Hemodynamics of volume loading compared with dobutamine in severe right ventricular infarction. Am J Cardiol. 1994;74(4):329–33.PubMedCrossRef
20.
Zurück zum Zitat Dell’Italia LJ, Starling MR, Blumhardt R, Lasher JC, O’Rourke RA. Comparative effects of volume loading, dobutamine, and nitroprusside in patients with predominant right ventricular infarction. Circulation. 1985;72(6):1327–35.PubMedCrossRef Dell’Italia LJ, Starling MR, Blumhardt R, Lasher JC, O’Rourke RA. Comparative effects of volume loading, dobutamine, and nitroprusside in patients with predominant right ventricular infarction. Circulation. 1985;72(6):1327–35.PubMedCrossRef
21.
Zurück zum Zitat Kerbaul F, Rondelet B, Motte S, Fesler P, Hubloue I, Ewalenko P, et al. Effects of norepinephrine and dobutamine on pressure load-induced right ventricular failure. Crit Care Med. 2004;32(4):1035–40.PubMedCrossRef Kerbaul F, Rondelet B, Motte S, Fesler P, Hubloue I, Ewalenko P, et al. Effects of norepinephrine and dobutamine on pressure load-induced right ventricular failure. Crit Care Med. 2004;32(4):1035–40.PubMedCrossRef
22.
Zurück zum Zitat Chen M, Edward P, Bittner M, Hartmuth B, Davis RD, Van Trigt III P. Milrinone improves pulmonary hemodynamics and right ventricular function in chronic pulmonary hypertension. Ann Thorac Surg. 1997;63(3):814–21. Elsevier.PubMedCrossRef Chen M, Edward P, Bittner M, Hartmuth B, Davis RD, Van Trigt III P. Milrinone improves pulmonary hemodynamics and right ventricular function in chronic pulmonary hypertension. Ann Thorac Surg. 1997;63(3):814–21. Elsevier.PubMedCrossRef
23.
Zurück zum Zitat Levy JH, Bailey JM, Deeb GM. Intravenous milrinone in cardiac surgery. Ann Thorac Surg. 2002;73(1):325–30.PubMedCrossRef Levy JH, Bailey JM, Deeb GM. Intravenous milrinone in cardiac surgery. Ann Thorac Surg. 2002;73(1):325–30.PubMedCrossRef
24.
Zurück zum Zitat Tayama E, Ueda T, Shojima T, Akasu K, Oda T, Fukunaga S, et al. Arginine vasopressin is an ideal drug after cardiac surgery for the management of low systemic vascular resistant hypotension concomitant with pulmonary hypertension. Interact Cardiovasc Thorac Surg. 2007;6(6):715–9. Oxford University Press.PubMedCrossRef Tayama E, Ueda T, Shojima T, Akasu K, Oda T, Fukunaga S, et al. Arginine vasopressin is an ideal drug after cardiac surgery for the management of low systemic vascular resistant hypotension concomitant with pulmonary hypertension. Interact Cardiovasc Thorac Surg. 2007;6(6):715–9. Oxford University Press.PubMedCrossRef
25.
Zurück zum Zitat Russ RD, Walker BR. Role of nitric oxide in vasopressinergic pulmonary vasodilatation. Am J Physiol. 1992;262(3 Pt 2):H743–7.PubMed Russ RD, Walker BR. Role of nitric oxide in vasopressinergic pulmonary vasodilatation. Am J Physiol. 1992;262(3 Pt 2):H743–7.PubMed
26.
Zurück zum Zitat Eichinger MR, Walker BR. Enhanced pulmonary arterial dilation to arginine vasopressin in chronically hypoxic rats. Am J Physiol. 1994;267(6 Pt 2):H2413–9.PubMed Eichinger MR, Walker BR. Enhanced pulmonary arterial dilation to arginine vasopressin in chronically hypoxic rats. Am J Physiol. 1994;267(6 Pt 2):H2413–9.PubMed
27.
Zurück zum Zitat Kwak YL, Lee CS, Park YH, Hong YW. The effect of phenylephrine and norepinephrine in patients with chronic pulmonary hypertension. Anaesthesia. 2002;57(1):9–14.PubMedCrossRef Kwak YL, Lee CS, Park YH, Hong YW. The effect of phenylephrine and norepinephrine in patients with chronic pulmonary hypertension. Anaesthesia. 2002;57(1):9–14.PubMedCrossRef
28.
Zurück zum Zitat Ghignone M, Girling L, Prewitt RM. Volume expansion versus norepinephrine in treatment of a low cardiac output complicating an acute increase in right ventricular afterload in dogs. Anesthesiology. 1984;60(2):132–5.PubMedCrossRef Ghignone M, Girling L, Prewitt RM. Volume expansion versus norepinephrine in treatment of a low cardiac output complicating an acute increase in right ventricular afterload in dogs. Anesthesiology. 1984;60(2):132–5.PubMedCrossRef
29.
Zurück zum Zitat Angle MR, Molloy DW, Penner B, Jones D, Prewitt RM. The cardiopulmonary and renal hemodynamic effects of norepinephrine in canine pulmonary embolism. Chest. 1989;95(6):1333–7.PubMedCrossRef Angle MR, Molloy DW, Penner B, Jones D, Prewitt RM. The cardiopulmonary and renal hemodynamic effects of norepinephrine in canine pulmonary embolism. Chest. 1989;95(6):1333–7.PubMedCrossRef
30.
Zurück zum Zitat Le Tulzo Y, Seguin P, Gacouin A, Camus C, Suprin E, Jouannic I, et al. Effects of epinephrine on right ventricular function in patients with severe septic shock and right ventricular failure: a preliminary descriptive study. Intensive Care Med. 1997;23(6):664–70.PubMedCrossRef Le Tulzo Y, Seguin P, Gacouin A, Camus C, Suprin E, Jouannic I, et al. Effects of epinephrine on right ventricular function in patients with severe septic shock and right ventricular failure: a preliminary descriptive study. Intensive Care Med. 1997;23(6):664–70.PubMedCrossRef
31.
Zurück zum Zitat Meldrum DR, Shames BD, Meng X, Fullerton DA, McIntyre RC, Grover FL, et al. Nitric oxide downregulates lung macrophage inflammatory cytokine production. Ann Thorac Surg. 1998;66(2):313–7.PubMedCrossRef Meldrum DR, Shames BD, Meng X, Fullerton DA, McIntyre RC, Grover FL, et al. Nitric oxide downregulates lung macrophage inflammatory cytokine production. Ann Thorac Surg. 1998;66(2):313–7.PubMedCrossRef
32.
Zurück zum Zitat Inglessis I, Shin JT, Lepore JJ, Palacios IF, Zapol WM, Bloch KD, et al. Hemodynamic effects of inhaled nitric oxide in right ventricular myocardial infarction and cardiogenic shock. J Am Coll Cardiol. 2004;44(4):793–8.PubMedCrossRef Inglessis I, Shin JT, Lepore JJ, Palacios IF, Zapol WM, Bloch KD, et al. Hemodynamic effects of inhaled nitric oxide in right ventricular myocardial infarction and cardiogenic shock. J Am Coll Cardiol. 2004;44(4):793–8.PubMedCrossRef
33.
Zurück zum Zitat Ardehali A, Hughes K, Sadeghi A, Esmailian F, Marelli D, Moriguchi J, et al. Inhaled nitric oxide for pulmonary hypertension after heart transplantation. Transplantation. 2001;72(4):638–41.PubMedCrossRef Ardehali A, Hughes K, Sadeghi A, Esmailian F, Marelli D, Moriguchi J, et al. Inhaled nitric oxide for pulmonary hypertension after heart transplantation. Transplantation. 2001;72(4):638–41.PubMedCrossRef
34.
Zurück zum Zitat Bradford KK, Deb B, Pearl RG. Combination therapy with inhaled nitric oxide and intravenous dobutamine during pulmonary hypertension in the rabbit. J Cardiovasc Pharmacol. 2000;36(2):146.PubMedCrossRef Bradford KK, Deb B, Pearl RG. Combination therapy with inhaled nitric oxide and intravenous dobutamine during pulmonary hypertension in the rabbit. J Cardiovasc Pharmacol. 2000;36(2):146.PubMedCrossRef
35.
Zurück zum Zitat Vizza CD, Rocca GD, Roma AD, Iacoboni C, Pierconti F, Venuta F, et al. Acute hemodynamic effects of inhaled nitric oxide, dobutamine and a combination of the two in patients with mild to moderate secondary pulmonary hypertension. Crit Care. 2001;5(6):355–61.PubMedCrossRef Vizza CD, Rocca GD, Roma AD, Iacoboni C, Pierconti F, Venuta F, et al. Acute hemodynamic effects of inhaled nitric oxide, dobutamine and a combination of the two in patients with mild to moderate secondary pulmonary hypertension. Crit Care. 2001;5(6):355–61.PubMedCrossRef
36.
Zurück zum Zitat Khazin V, Kaufman Y, Zabeeda D, Medalion B, Sasson L, Schachner A, et al. Milrinone and nitric oxide: combined effect on pulmonary artery pressures after cardiopulmonary bypass in children. J Cardiothorac Vasc Anesth. 2004;18(2):156–9.PubMedCrossRef Khazin V, Kaufman Y, Zabeeda D, Medalion B, Sasson L, Schachner A, et al. Milrinone and nitric oxide: combined effect on pulmonary artery pressures after cardiopulmonary bypass in children. J Cardiothorac Vasc Anesth. 2004;18(2):156–9.PubMedCrossRef
37.
Zurück zum Zitat Christenson J, Lavoie A, O’Connor M, Bhorade S, Pohlman A, Hall JB. The incidence and pathogenesis of cardiopulmonary deterioration after abrupt withdrawal of inhaled nitric oxide. Am J Respir Crit Care Med. 2000;161(5):1443–9.PubMed Christenson J, Lavoie A, O’Connor M, Bhorade S, Pohlman A, Hall JB. The incidence and pathogenesis of cardiopulmonary deterioration after abrupt withdrawal of inhaled nitric oxide. Am J Respir Crit Care Med. 2000;161(5):1443–9.PubMed
38.
Zurück zum Zitat Loh E, Stamler JS, Hare JM, Loscalzo J, Colucci WS. Cardiovascular effects of inhaled nitric oxide in patients with left ventricular dysfunction. Circulation. 1994;90(6):2780–5. Am Heart Assoc.PubMedCrossRef Loh E, Stamler JS, Hare JM, Loscalzo J, Colucci WS. Cardiovascular effects of inhaled nitric oxide in patients with left ventricular dysfunction. Circulation. 1994;90(6):2780–5. Am Heart Assoc.PubMedCrossRef
39.
Zurück zum Zitat Semigran MJ, Cockrill BA, Kacmarek R, Thompson BT, Zapol WM, Dec GW, et al. Hemodynamic effects of inhaled nitric oxide in heart failure. J Am Coll Cardiol. 1994;24(4):982–8. Elsevier.PubMedCrossRef Semigran MJ, Cockrill BA, Kacmarek R, Thompson BT, Zapol WM, Dec GW, et al. Hemodynamic effects of inhaled nitric oxide in heart failure. J Am Coll Cardiol. 1994;24(4):982–8. Elsevier.PubMedCrossRef
40.
Zurück zum Zitat Khan TA, Schnickel G, Ross D, Bastani S, Laks H, Esmailian F, et al. A prospective, randomized, crossover pilot study of inhaled nitric oxide versus inhaled prostacyclin in heart transplant and lung transplant recipients. J Thorac Cardiovasc Surg. 2009;138(6):1417–24.PubMedCrossRef Khan TA, Schnickel G, Ross D, Bastani S, Laks H, Esmailian F, et al. A prospective, randomized, crossover pilot study of inhaled nitric oxide versus inhaled prostacyclin in heart transplant and lung transplant recipients. J Thorac Cardiovasc Surg. 2009;138(6):1417–24.PubMedCrossRef
41.
Zurück zum Zitat Gordon C, Collard CD, Pan W. Intraoperative management of pulmonary hypertension and associated right heart failure. Curr Opin Anaesthesiol. 2010;23(1):49–56.PubMedCrossRef Gordon C, Collard CD, Pan W. Intraoperative management of pulmonary hypertension and associated right heart failure. Curr Opin Anaesthesiol. 2010;23(1):49–56.PubMedCrossRef
42.
Zurück zum Zitat Sastry BKS, Narasimhan C, Reddy NK, Raju BS. Clinical efficacy of sildenafil in primary pulmonary hypertension: a randomized, placebo-controlled, double-blind, crossover study. J Am Coll Cardiol. 2004;43(7):1149–53.PubMedCrossRef Sastry BKS, Narasimhan C, Reddy NK, Raju BS. Clinical efficacy of sildenafil in primary pulmonary hypertension: a randomized, placebo-controlled, double-blind, crossover study. J Am Coll Cardiol. 2004;43(7):1149–53.PubMedCrossRef
43.
Zurück zum Zitat Trachte AL, Lobato EB, Urdaneta F, Hess PJ, Klodell CT, Martin TD, et al. Oral sildenafil reduces pulmonary hypertension after cardiac surgery. Ann Thorac Surg. 2005;79(1):194–7. discussion194–7.PubMedCrossRef Trachte AL, Lobato EB, Urdaneta F, Hess PJ, Klodell CT, Martin TD, et al. Oral sildenafil reduces pulmonary hypertension after cardiac surgery. Ann Thorac Surg. 2005;79(1):194–7. discussion194–7.PubMedCrossRef
44.
Zurück zum Zitat ••Tedford RJ, Hemnes AR, Russell SD, Wittstein IS, Mahmud M, Zaiman AL, et al. PDE5A inhibitor treatment of persistent pulmonary hypertension after mechanical circulatory support. Circ Heart Fail. 2008;1(4):213–9. Persistent pulmonary hypertension and right ventricular dysfunction are risk factors for mortality in end-stage heart failure patients after institution of mechanical circulatory support. This paper suggests that PDE5 inhibitors may improve residual pulmonary hypertension and cardiac output after LVAD implantation.PubMedCrossRef ••Tedford RJ, Hemnes AR, Russell SD, Wittstein IS, Mahmud M, Zaiman AL, et al. PDE5A inhibitor treatment of persistent pulmonary hypertension after mechanical circulatory support. Circ Heart Fail. 2008;1(4):213–9. Persistent pulmonary hypertension and right ventricular dysfunction are risk factors for mortality in end-stage heart failure patients after institution of mechanical circulatory support. This paper suggests that PDE5 inhibitors may improve residual pulmonary hypertension and cardiac output after LVAD implantation.PubMedCrossRef
45.
Zurück zum Zitat Lewis GD, Shah R, Shahzad K, Camuso JM, Pappagianopoulos PP, Hung J, et al. Sildenafil improves exercise capacity and quality of life in patients with systolic heart failure and secondary pulmonary hypertension. Circulation. 2007;116:1555–62. Lewis GD, Shah R, Shahzad K, Camuso JM, Pappagianopoulos PP, Hung J, et al. Sildenafil improves exercise capacity and quality of life in patients with systolic heart failure and secondary pulmonary hypertension. Circulation. 2007;116:1555–62.
46.
Zurück zum Zitat Nagendran J, Archer SL, Soliman D, Gurtu V, Moudgil R, Haromy A, et al. Phosphodiesterase Type 5 is highly expressed in the hypertrophied human right ventricle, and acute inhibition of phosphodiesterase Type 5 improves contractility. Circulation. 2007;116:238–48.PubMedCrossRef Nagendran J, Archer SL, Soliman D, Gurtu V, Moudgil R, Haromy A, et al. Phosphodiesterase Type 5 is highly expressed in the hypertrophied human right ventricle, and acute inhibition of phosphodiesterase Type 5 improves contractility. Circulation. 2007;116:238–48.PubMedCrossRef
47.
Zurück zum Zitat Love JC, Haffajee CI, Gore JM, Alpert JS. Reversibility of hypotension and shock by atrial or atrioventricular sequential pacing in patients with right ventricular infarction. Am Heart J. 1984;108(1):5–13.PubMedCrossRef Love JC, Haffajee CI, Gore JM, Alpert JS. Reversibility of hypotension and shock by atrial or atrioventricular sequential pacing in patients with right ventricular infarction. Am Heart J. 1984;108(1):5–13.PubMedCrossRef
48.
Zurück zum Zitat Topol EJ, Goldschlager N, Ports TA, Dicarlo LA, Schiller NB, Botvinick EH, et al. Hemodynamic benefit of atrial pacing in right ventricular myocardial infarction. Ann Intern Med. 1982;96(5):594–7.PubMed Topol EJ, Goldschlager N, Ports TA, Dicarlo LA, Schiller NB, Botvinick EH, et al. Hemodynamic benefit of atrial pacing in right ventricular myocardial infarction. Ann Intern Med. 1982;96(5):594–7.PubMed
49.
Zurück zum Zitat Dubin AM, Feinstein JA, Reddy VM, Hanley FL, Van Hare GF, Rosenthal DN. Electrical resynchronization: a novel therapy for the failing right ventricle. Circulation. 2003;107(18):2287–9.PubMedCrossRef Dubin AM, Feinstein JA, Reddy VM, Hanley FL, Van Hare GF, Rosenthal DN. Electrical resynchronization: a novel therapy for the failing right ventricle. Circulation. 2003;107(18):2287–9.PubMedCrossRef
50.
Zurück zum Zitat Kahn D. Postinfarct refractory right ventricle: right ventricular exclusion. A possible option to mechanical cardiac support, in patients unsuitable for heart transplant. J Cardiovasc Surg. 2000;41(3):349–55. Kahn D. Postinfarct refractory right ventricle: right ventricular exclusion. A possible option to mechanical cardiac support, in patients unsuitable for heart transplant. J Cardiovasc Surg. 2000;41(3):349–55.
51.
Zurück zum Zitat Hangler HB, Bonatti JO, Antretter H, Mair P, Müller LC. Isolated right ventricular assist for postcardiotomy myocardial infarction. Ann Thorac Surg. 1999;68(6):2326–8.PubMedCrossRef Hangler HB, Bonatti JO, Antretter H, Mair P, Müller LC. Isolated right ventricular assist for postcardiotomy myocardial infarction. Ann Thorac Surg. 1999;68(6):2326–8.PubMedCrossRef
52.
Zurück zum Zitat Moazami N, Pasque MK, Moon MR, Herren RL, Bailey MS, Lawton JS, et al. Mechanical support for isolated right ventricular failure in patients after cardiotomy. J Heart Lung Transplant. 2004;23(12):1371–5. Elsevier.PubMedCrossRef Moazami N, Pasque MK, Moon MR, Herren RL, Bailey MS, Lawton JS, et al. Mechanical support for isolated right ventricular failure in patients after cardiotomy. J Heart Lung Transplant. 2004;23(12):1371–5. Elsevier.PubMedCrossRef
53.
Zurück zum Zitat Furukawa K, Motomura T, Nosé Y. Right ventricular failure after left ventricular assist device implantation: the need for an implantable right ventricular assist device. Artif Organs. 2005;29(5):369–77. Wiley Online Library.PubMedCrossRef Furukawa K, Motomura T, Nosé Y. Right ventricular failure after left ventricular assist device implantation: the need for an implantable right ventricular assist device. Artif Organs. 2005;29(5):369–77. Wiley Online Library.PubMedCrossRef
54.
Zurück zum Zitat Klima U, Ringes-Lichtenberg S, Warnecke G, Lichtenberg A, Struber M, Haverich A. Severe right heart failure after heart transplantation. A single-center experience. Transplant Int. 2005;18(3):326–32.CrossRef Klima U, Ringes-Lichtenberg S, Warnecke G, Lichtenberg A, Struber M, Haverich A. Severe right heart failure after heart transplantation. A single-center experience. Transplant Int. 2005;18(3):326–32.CrossRef
55.
Zurück zum Zitat Berman M, Tsui S, Vuylsteke A, Klein A, Jenkins DP. Life-threatening right ventricular failure in pulmonary hypertension: RVAD or ECMO? J Heart Lung Transplant. 2008;27(10):1188–9.PubMedCrossRef Berman M, Tsui S, Vuylsteke A, Klein A, Jenkins DP. Life-threatening right ventricular failure in pulmonary hypertension: RVAD or ECMO? J Heart Lung Transplant. 2008;27(10):1188–9.PubMedCrossRef
56.
Zurück zum Zitat ••Berman M, Tsui S, Vuylsteke A, Snell A, Colah S, Latimer R, et al. Successful extracorporeal membrane oxygenation support after pulmonary thromboendarterectomy. Ann Thorac Surg. 2008;86(4):1261–7. Patients with persistent pulmonary hypertension following pulmonary thromboendarterectomy have a high rate of mortality. This paper reports the successful use of VA-ECMO for complete cardiorespiratory support in aiding their recovery.PubMedCrossRef ••Berman M, Tsui S, Vuylsteke A, Snell A, Colah S, Latimer R, et al. Successful extracorporeal membrane oxygenation support after pulmonary thromboendarterectomy. Ann Thorac Surg. 2008;86(4):1261–7. Patients with persistent pulmonary hypertension following pulmonary thromboendarterectomy have a high rate of mortality. This paper reports the successful use of VA-ECMO for complete cardiorespiratory support in aiding their recovery.PubMedCrossRef
57.
Zurück zum Zitat Conrad SA, Rycus PT, Dalton H. Extracorporeal life support registry report 2004. ASAIO J. 2005;51(1):4–10.PubMedCrossRef Conrad SA, Rycus PT, Dalton H. Extracorporeal life support registry report 2004. ASAIO J. 2005;51(1):4–10.PubMedCrossRef
58.
Zurück zum Zitat Rozkovec A, Montanes P, Oakley CM. Factors that influence the outcome of primary pulmonary hypertension. Heart. 1986;55(5):449–58.CrossRef Rozkovec A, Montanes P, Oakley CM. Factors that influence the outcome of primary pulmonary hypertension. Heart. 1986;55(5):449–58.CrossRef
59.
Zurück zum Zitat Hopkins WE, Ochoa LL, Richardson GW, Trulock EP. Comparison of the hemodynamics and survival of adults with severe primary pulmonary hypertension or Eisenmenger syndrome. J Heart Lung Transplant. 1996;15(1 Pt 1):100–5.PubMed Hopkins WE, Ochoa LL, Richardson GW, Trulock EP. Comparison of the hemodynamics and survival of adults with severe primary pulmonary hypertension or Eisenmenger syndrome. J Heart Lung Transplant. 1996;15(1 Pt 1):100–5.PubMed
60.
Zurück zum Zitat Sandoval J, Gaspar J, Pulido T, Bautista E, Martínez-Guerra ML, Zeballos M, et al. Graded balloon dilation atrial septostomy in severe primary pulmonary hypertension. A therapeutic alternative for patients nonresponsive to vasodilator treatment. J Am Coll Cardiol. 1998;32(2):297–304.PubMedCrossRef Sandoval J, Gaspar J, Pulido T, Bautista E, Martínez-Guerra ML, Zeballos M, et al. Graded balloon dilation atrial septostomy in severe primary pulmonary hypertension. A therapeutic alternative for patients nonresponsive to vasodilator treatment. J Am Coll Cardiol. 1998;32(2):297–304.PubMedCrossRef
61.
Zurück zum Zitat Rich S, Dodin E, McLaughlin VV. Usefulness of atrial septostomy as a treatment for primary pulmonary hypertension and guidelines for its application. Am J Cardiol. 1997;80(3):369–71.PubMedCrossRef Rich S, Dodin E, McLaughlin VV. Usefulness of atrial septostomy as a treatment for primary pulmonary hypertension and guidelines for its application. Am J Cardiol. 1997;80(3):369–71.PubMedCrossRef
62.
Zurück zum Zitat Blanc J, Vouhé P, Bonnet D. Potts shunt in patients with pulmonary hypertension. N Engl J Med. 2004;350(6):623–3. Mass Medical Soc.PubMedCrossRef Blanc J, Vouhé P, Bonnet D. Potts shunt in patients with pulmonary hypertension. N Engl J Med. 2004;350(6):623–3. Mass Medical Soc.PubMedCrossRef
Metadaten
Titel
Management of Acute Right Ventricular Failure in the Intensive Care Unit
verfasst von
Eric M. Green
Michael M. Givertz
Publikationsdatum
01.09.2012
Verlag
Current Science Inc.
Erschienen in
Current Heart Failure Reports / Ausgabe 3/2012
Print ISSN: 1546-9530
Elektronische ISSN: 1546-9549
DOI
https://doi.org/10.1007/s11897-012-0104-x

Weitere Artikel der Ausgabe 3/2012

Current Heart Failure Reports 3/2012 Zur Ausgabe

Decompensated Heart Failure (MM Givertz, Section editor)

Congestion Is the Driving Force Behind Heart Failure

Decompensated Heart Failure (MM Givertz, Section editor)

Diuretic Dosing in Acute Decompensated Heart Failure: Lessons from DOSE

Investigative Therapies (J.-L. Balligand, Section editor)

16-kDa Prolactin and Bromocriptine in Postpartum Cardiomyopathy

Screening-Mammografie offenbart erhöhtes Herz-Kreislauf-Risiko

26.04.2024 Mammografie Nachrichten

Routinemäßige Mammografien helfen, Brustkrebs frühzeitig zu erkennen. Anhand der Röntgenuntersuchung lassen sich aber auch kardiovaskuläre Risikopatientinnen identifizieren. Als zuverlässiger Anhaltspunkt gilt die Verkalkung der Brustarterien.

Niedriger diastolischer Blutdruck erhöht Risiko für schwere kardiovaskuläre Komplikationen

25.04.2024 Hypotonie Nachrichten

Wenn unter einer medikamentösen Hochdrucktherapie der diastolische Blutdruck in den Keller geht, steigt das Risiko für schwere kardiovaskuläre Ereignisse: Darauf deutet eine Sekundäranalyse der SPRINT-Studie hin.

Therapiestart mit Blutdrucksenkern erhöht Frakturrisiko

25.04.2024 Hypertonie Nachrichten

Beginnen ältere Männer im Pflegeheim eine Antihypertensiva-Therapie, dann ist die Frakturrate in den folgenden 30 Tagen mehr als verdoppelt. Besonders häufig stürzen Demenzkranke und Männer, die erstmals Blutdrucksenker nehmen. Dafür spricht eine Analyse unter US-Veteranen.

Adipositas-Medikament auch gegen Schlafapnoe wirksam

24.04.2024 Adipositas Nachrichten

Der als Antidiabetikum sowie zum Gewichtsmanagement zugelassene Wirkstoff Tirzepatid hat in Studien bei adipösen Patienten auch schlafbezogene Atmungsstörungen deutlich reduziert, informiert der Hersteller in einer Vorab-Meldung zum Studienausgang.

Update Kardiologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.