Skip to main content
Erschienen in: Critical Care 3/2006

01.06.2006 | Review

What role does the right side of the heart play in circulation?

verfasst von: Maurizio Cecconi, Edward Johnston, Andrew Rhodes

Erschienen in: Critical Care | Sonderheft 3/2006

Einloggen, um Zugang zu erhalten

Abstract

Right ventricular failure (RVF) is an underestimated problem in intensive care. This review explores the physiology and pathophysiology of right ventricular function and the pulmonary circulation. When RVF is secondary to an acute increase in afterload, the picture is one of acute cor pulmonale, as occurs in the context of acute respiratory distress syndrome, pulmonary embolism and sepsis. RVF can also be caused by right myocardial dysfunction. Pulmonary arterial catheterization and echocardiography are discussed in terms of their roles in diagnosis and treatment. Treatments include options to reduce right ventricular afterload, specific pulmonary vasodilators and inotropes.
Literatur
1.
Zurück zum Zitat Matthews LR, (editor): Cardiopulmonary Anatomy and Physiology. Philadelphia: Lippincott-Raven Publishers; 1996. Matthews LR, (editor): Cardiopulmonary Anatomy and Physiology. Philadelphia: Lippincott-Raven Publishers; 1996.
2.
Zurück zum Zitat Brieke A, DeNofrio D: Right ventricular dysfunction in chronic dilated cardiomyopathy and heart failure. Coron Artery Dis 2005, 16: 5-11. 10.1097/00019501-200502000-00002CrossRefPubMed Brieke A, DeNofrio D: Right ventricular dysfunction in chronic dilated cardiomyopathy and heart failure. Coron Artery Dis 2005, 16: 5-11. 10.1097/00019501-200502000-00002CrossRefPubMed
3.
Zurück zum Zitat Sarnoff SJ, Berglund E: Ventricular function. I. Starling's law of the heart studied by means of simultaneous right and left ventricular function curves in the dog. Circulation 1954, 9: 706-718.CrossRefPubMed Sarnoff SJ, Berglund E: Ventricular function. I. Starling's law of the heart studied by means of simultaneous right and left ventricular function curves in the dog. Circulation 1954, 9: 706-718.CrossRefPubMed
4.
Zurück zum Zitat Jardin F, Viellard-Baron A: Monitoring of right sided heart function. Curr Opin Crit Care 2005, 11: 271-279. 10.1097/01.ccx.0000158847.56107.55CrossRefPubMed Jardin F, Viellard-Baron A: Monitoring of right sided heart function. Curr Opin Crit Care 2005, 11: 271-279. 10.1097/01.ccx.0000158847.56107.55CrossRefPubMed
5.
Zurück zum Zitat Mebazaa A, Karpati P, Renaud E, Algotsson L: Acute right ventricular failure – from pathophysiology to new treatments. Intensive Care Med 2004, 30: 185-196. 10.1007/s00134-003-2025-3CrossRefPubMed Mebazaa A, Karpati P, Renaud E, Algotsson L: Acute right ventricular failure – from pathophysiology to new treatments. Intensive Care Med 2004, 30: 185-196. 10.1007/s00134-003-2025-3CrossRefPubMed
6.
Zurück zum Zitat Matthay RA, Arroliga AC, Wiedemann HP, Schulman DS, Mahler DA: Right ventricular function at rest and during exercise in chronic obstructive pulmonary disease. Chest 1992, (Suppl):255S-262S. Matthay RA, Arroliga AC, Wiedemann HP, Schulman DS, Mahler DA: Right ventricular function at rest and during exercise in chronic obstructive pulmonary disease. Chest 1992, (Suppl):255S-262S.
7.
Zurück zum Zitat Vieillard-Baron A, Prin S, Chergui K, Dubourg O, Jardin F: Echo-Doppler demonstration of acute cor pulmonale at the bedside in the medical intensive care unit. Am J Respir Crit Care Med 2002, 166: 1310-1319. 10.1164/rccm.200202-146CCCrossRefPubMed Vieillard-Baron A, Prin S, Chergui K, Dubourg O, Jardin F: Echo-Doppler demonstration of acute cor pulmonale at the bedside in the medical intensive care unit. Am J Respir Crit Care Med 2002, 166: 1310-1319. 10.1164/rccm.200202-146CCCrossRefPubMed
8.
Zurück zum Zitat Vieillard-Baron A, Schimtt JM, Augarde R, Fellahi JL, Prin S, Page B, Beauchet A, Jardin F: Acute core pulmonale in acute distress syndrome submitted to protective ventilation: incidence, clinical implications and prognosis. Crit Care Med 2001, 29: 1551-1555. 10.1097/00003246-200108000-00009CrossRefPubMed Vieillard-Baron A, Schimtt JM, Augarde R, Fellahi JL, Prin S, Page B, Beauchet A, Jardin F: Acute core pulmonale in acute distress syndrome submitted to protective ventilation: incidence, clinical implications and prognosis. Crit Care Med 2001, 29: 1551-1555. 10.1097/00003246-200108000-00009CrossRefPubMed
9.
Zurück zum Zitat Jardin F: Ventricular interdependence: how does it impact on hemodynamic evaluation in clinical practice? Intensive Care Med 2003, 29: 361-363. 10.1007/s00134-003-1873-1CrossRefPubMed Jardin F: Ventricular interdependence: how does it impact on hemodynamic evaluation in clinical practice? Intensive Care Med 2003, 29: 361-363. 10.1007/s00134-003-1873-1CrossRefPubMed
10.
Zurück zum Zitat Guarracino F, Carriello C, Danella A, Doroni L, Lapolla F, Vullo C, Pasquini C, Stefani M: Right Ventricular failure: physiology and assessment. Min Anest 2005, 71: 307-312. Guarracino F, Carriello C, Danella A, Doroni L, Lapolla F, Vullo C, Pasquini C, Stefani M: Right Ventricular failure: physiology and assessment. Min Anest 2005, 71: 307-312.
11.
Zurück zum Zitat Jardin F, Dubourg O, Gueret P, Delorme G, Bourdarias JP: Quantitative two dimensional echocardiography in massive pulmonary embolism: emphasis on ventricular interdependence and leftward septal displacement. J Am Coll Cardiol 1987, 10: 1201-1206.CrossRefPubMed Jardin F, Dubourg O, Gueret P, Delorme G, Bourdarias JP: Quantitative two dimensional echocardiography in massive pulmonary embolism: emphasis on ventricular interdependence and leftward septal displacement. J Am Coll Cardiol 1987, 10: 1201-1206.CrossRefPubMed
12.
Zurück zum Zitat Morris-Thurgood JA, Frenneaux MP: Diastolic ventricular interaction and ventricular diastolic filling. Heart Fail Rev 2000, 5: 307-323. 10.1023/A:1026555012135CrossRefPubMed Morris-Thurgood JA, Frenneaux MP: Diastolic ventricular interaction and ventricular diastolic filling. Heart Fail Rev 2000, 5: 307-323. 10.1023/A:1026555012135CrossRefPubMed
13.
Zurück zum Zitat Belenkie I, Dani R, Smith ER, Tyberg JV: The importance of pericardial constraint in experimental pulmonary embolism and volume loading. Am Heart J 1992, 123: 733-742. 10.1016/0002-8703(92)90514-VCrossRefPubMed Belenkie I, Dani R, Smith ER, Tyberg JV: The importance of pericardial constraint in experimental pulmonary embolism and volume loading. Am Heart J 1992, 123: 733-742. 10.1016/0002-8703(92)90514-VCrossRefPubMed
14.
Zurück zum Zitat Mercat A, Diehl JL, Meyer G, Teboul JL, Sors H: Hemodynamic effects of fluid loading in acute massive pulmonary embolism. Crit Care Med 1999, 27: 540-544. 10.1097/00003246-199903000-00032CrossRefPubMed Mercat A, Diehl JL, Meyer G, Teboul JL, Sors H: Hemodynamic effects of fluid loading in acute massive pulmonary embolism. Crit Care Med 1999, 27: 540-544. 10.1097/00003246-199903000-00032CrossRefPubMed
15.
Zurück zum Zitat Jardin F, Gueret P, Dubourg O, Farcot JC, Margairaz A, Bourdarias JP: Two dimensional echocardiographic evaluation of right ventricular size and contractility in acute respiratory failure. Crit Care Med 1985, 13: 952-956.CrossRefPubMed Jardin F, Gueret P, Dubourg O, Farcot JC, Margairaz A, Bourdarias JP: Two dimensional echocardiographic evaluation of right ventricular size and contractility in acute respiratory failure. Crit Care Med 1985, 13: 952-956.CrossRefPubMed
16.
Zurück zum Zitat Schneider AJ, Teule GJ, Groeneveld AB, Nauta J, Heidendal GA, Thijs LG: Biventricular performance during volume loading in patients with early septic shock, with emphasis on the right ventricle: a combined hemodynaic and radionuclide study. Am Heart J 1988, 116: 103-112. 10.1016/0002-8703(88)90256-6CrossRefPubMed Schneider AJ, Teule GJ, Groeneveld AB, Nauta J, Heidendal GA, Thijs LG: Biventricular performance during volume loading in patients with early septic shock, with emphasis on the right ventricle: a combined hemodynaic and radionuclide study. Am Heart J 1988, 116: 103-112. 10.1016/0002-8703(88)90256-6CrossRefPubMed
17.
Zurück zum Zitat Jardin F, Brun-Ney D, Auvert B, Beauchet A, Bourdarias JP: Sepsis related cardiogenic shock. Crit Care Med 1990, 18: 1055-1060. 10.1097/00003246-199010000-00001CrossRefPubMed Jardin F, Brun-Ney D, Auvert B, Beauchet A, Bourdarias JP: Sepsis related cardiogenic shock. Crit Care Med 1990, 18: 1055-1060. 10.1097/00003246-199010000-00001CrossRefPubMed
18.
Zurück zum Zitat Ghio S, Gavazzi A, Campana C, Inserra C, Klersky C, Sebastiani R, Arbustini E, Recusani F, Tavazzi L: Independent and additive prognostic value of right systolic function and pulmonary artery pressure in patients with chronic heart failure. J Am Coll Cardiol 2001, 37: 183-188. 10.1016/S0735-1097(00)01102-5CrossRefPubMed Ghio S, Gavazzi A, Campana C, Inserra C, Klersky C, Sebastiani R, Arbustini E, Recusani F, Tavazzi L: Independent and additive prognostic value of right systolic function and pulmonary artery pressure in patients with chronic heart failure. J Am Coll Cardiol 2001, 37: 183-188. 10.1016/S0735-1097(00)01102-5CrossRefPubMed
19.
Zurück zum Zitat Jacobs AK, Leopold JA, Bates E, Mendes LA, Sleeper LA, White H, Davidoff R, Boland J, Modur S, Forman R, et al.: Cardiogenic shock caused by right ventricular infarction: a report from the SHOCK registry. J Am Coll Cardiol 2003, 41: 1273-1279. 10.1016/S0735-1097(03)00120-7CrossRefPubMed Jacobs AK, Leopold JA, Bates E, Mendes LA, Sleeper LA, White H, Davidoff R, Boland J, Modur S, Forman R, et al.: Cardiogenic shock caused by right ventricular infarction: a report from the SHOCK registry. J Am Coll Cardiol 2003, 41: 1273-1279. 10.1016/S0735-1097(03)00120-7CrossRefPubMed
20.
Zurück zum Zitat Pfisterer M: Right ventricular involvement in myocardial infarction and cardiogenic shock. Lancet 2003, 362: 392-394. 10.1016/S0140-6736(03)14028-7CrossRefPubMed Pfisterer M: Right ventricular involvement in myocardial infarction and cardiogenic shock. Lancet 2003, 362: 392-394. 10.1016/S0140-6736(03)14028-7CrossRefPubMed
21.
Zurück zum Zitat Santamore WP, Gray L Jr: Significant left ventricular contribution to right ventricular systolic function. Mechanism and clinical implications. Chest 1995, 107: 1134-1145.CrossRefPubMed Santamore WP, Gray L Jr: Significant left ventricular contribution to right ventricular systolic function. Mechanism and clinical implications. Chest 1995, 107: 1134-1145.CrossRefPubMed
22.
Zurück zum Zitat Klima U, Guerrero JL, Vlahakes GJ: Contribution of the interventricular septum to maximal right ventricular function. Eur J Cardiothorac Surg 1998, 14: 250-255. 10.1016/S1010-7940(98)00179-1CrossRefPubMed Klima U, Guerrero JL, Vlahakes GJ: Contribution of the interventricular septum to maximal right ventricular function. Eur J Cardiothorac Surg 1998, 14: 250-255. 10.1016/S1010-7940(98)00179-1CrossRefPubMed
23.
Zurück zum Zitat Ganz W, Donoso R, Marcus HS, Forrester JS, Swan HJ: A new technique for measurement of cardiac output by thermodilution in man. Am J Cardiol 1971, 27: 392-396. 10.1016/0002-9149(71)90436-XCrossRefPubMed Ganz W, Donoso R, Marcus HS, Forrester JS, Swan HJ: A new technique for measurement of cardiac output by thermodilution in man. Am J Cardiol 1971, 27: 392-396. 10.1016/0002-9149(71)90436-XCrossRefPubMed
24.
Zurück zum Zitat Boldt J, Menges T, Wollbruck M, Hammermann H, Hempelmann G: Is continuous cardiac output measurement using thermodilution reliable in the critically ill patient? Crit Care Med 1994, 22: 1913-1918.CrossRefPubMed Boldt J, Menges T, Wollbruck M, Hammermann H, Hempelmann G: Is continuous cardiac output measurement using thermodilution reliable in the critically ill patient? Crit Care Med 1994, 22: 1913-1918.CrossRefPubMed
25.
Zurück zum Zitat Munro HM, Wood CE, Taylor BL, Smith GB: Continuous invasive cardiac output monitoring – the Baxter/Edwards Critical-Care Swan Ganz ® Intellicath™ and Vigilance™ system. Clin Intensive Care 1994, 5: 52-55.PubMed Munro HM, Wood CE, Taylor BL, Smith GB: Continuous invasive cardiac output monitoring – the Baxter/Edwards Critical-Care Swan Ganz ® Intellicath™ and Vigilance™ system. Clin Intensive Care 1994, 5: 52-55.PubMed
26.
Zurück zum Zitat Cheatham ML: Right ventricular end-diastolic volume measurements in the resuscitation of trauma victims. Int J Crit Care 2000, 7: 165-176. Cheatham ML: Right ventricular end-diastolic volume measurements in the resuscitation of trauma victims. Int J Crit Care 2000, 7: 165-176.
27.
Zurück zum Zitat Vignon P: Hemodynamic assessment of critically ill patients using echocardiography Doppler. Curr Opin Crit Care 2005, 11: 227-234. 10.1097/01.ccx.0000159946.89658.51CrossRefPubMed Vignon P: Hemodynamic assessment of critically ill patients using echocardiography Doppler. Curr Opin Crit Care 2005, 11: 227-234. 10.1097/01.ccx.0000159946.89658.51CrossRefPubMed
28.
Zurück zum Zitat Bowers TR, O'Neill WW, Grines C, Pica MC, Safian RD, Goldstein JA: Effect of reperfusion on biventricular function and survival after right ventricular infarction. N Engl J Med 1998, 338: 933-940. 10.1056/NEJM199804023381401CrossRefPubMed Bowers TR, O'Neill WW, Grines C, Pica MC, Safian RD, Goldstein JA: Effect of reperfusion on biventricular function and survival after right ventricular infarction. N Engl J Med 1998, 338: 933-940. 10.1056/NEJM199804023381401CrossRefPubMed
29.
Zurück zum Zitat Kinn JW, Ajluni SC, Samyn JG, Bates ER, Grines CL, O'Neil W: Rapid hemodynamic improvement after reperfusion during right ventricular infarction. J Am Coll Cardiol 1995, 26: 1230-1234. 10.1016/0735-1097(95)00311-8CrossRefPubMed Kinn JW, Ajluni SC, Samyn JG, Bates ER, Grines CL, O'Neil W: Rapid hemodynamic improvement after reperfusion during right ventricular infarction. J Am Coll Cardiol 1995, 26: 1230-1234. 10.1016/0735-1097(95)00311-8CrossRefPubMed
30.
Zurück zum Zitat Sibbald WJ, Driedger AA: Right ventricular function in acute disease states: pathophysiologic considerations. Crit Care Med 1983, 11: 339-345.CrossRefPubMed Sibbald WJ, Driedger AA: Right ventricular function in acute disease states: pathophysiologic considerations. Crit Care Med 1983, 11: 339-345.CrossRefPubMed
31.
Zurück zum Zitat Atherton JJ, Moore TD, Lele SS, Thomson HL, Galbraith AJ, Belenkie I, Tyberg JV, Frenneaux MP: Diastolic ventricular interaction in chronic heart failure. Lancet 1997, 349: 1720-1724. 10.1016/S0140-6736(96)05109-4CrossRefPubMed Atherton JJ, Moore TD, Lele SS, Thomson HL, Galbraith AJ, Belenkie I, Tyberg JV, Frenneaux MP: Diastolic ventricular interaction in chronic heart failure. Lancet 1997, 349: 1720-1724. 10.1016/S0140-6736(96)05109-4CrossRefPubMed
32.
Zurück zum Zitat Michard F, Boussat S, Chemla D, Anguel N, mercat A, Lecarpentier Y, Richard C, Pinsky MR, Teboul JL: Relation between respiratory changes in arterial pulse pressure and fluid responsiveness in septic patients with acute circulatory failure. Am J Respir Crit Care Med 2000, 162: 134-138.CrossRefPubMed Michard F, Boussat S, Chemla D, Anguel N, mercat A, Lecarpentier Y, Richard C, Pinsky MR, Teboul JL: Relation between respiratory changes in arterial pulse pressure and fluid responsiveness in septic patients with acute circulatory failure. Am J Respir Crit Care Med 2000, 162: 134-138.CrossRefPubMed
33.
Zurück zum Zitat Pepke-Zaba J, Higenbottam TW, Dinh-Xuan AT, Stone D, Wallwork J: Inhaled nitric oxide as a cause of selective pulmonary vasodilatation in pulmonary hypertension. Lancet 1991, 338: 1173-1174. 10.1016/0140-6736(91)92033-XCrossRefPubMed Pepke-Zaba J, Higenbottam TW, Dinh-Xuan AT, Stone D, Wallwork J: Inhaled nitric oxide as a cause of selective pulmonary vasodilatation in pulmonary hypertension. Lancet 1991, 338: 1173-1174. 10.1016/0140-6736(91)92033-XCrossRefPubMed
34.
Zurück zum Zitat Bundgaard H, Boesgaard S, Mortensen SA, Arendrup H, Aldershvile J: Effect of nitroglycerin in patients with increased pulmonary vascular resistance undergoing cardiac transplantation. Scand Cardiovasc J 1997, 31: 339-342.CrossRefPubMed Bundgaard H, Boesgaard S, Mortensen SA, Arendrup H, Aldershvile J: Effect of nitroglycerin in patients with increased pulmonary vascular resistance undergoing cardiac transplantation. Scand Cardiovasc J 1997, 31: 339-342.CrossRefPubMed
35.
Zurück zum Zitat Vincent JL, Carlier E, Pinsky MR, Goldstein J, Naeije R, Lejeune P, Brimioulle S, Leclerc JL, Kahn RJ, Primo G: Prostaglandin E 1 infusion for right ventricular failure after cardiac transplantation. J Thorac Cardiovasc Surg 1992, 103: 33-39.PubMed Vincent JL, Carlier E, Pinsky MR, Goldstein J, Naeije R, Lejeune P, Brimioulle S, Leclerc JL, Kahn RJ, Primo G: Prostaglandin E 1 infusion for right ventricular failure after cardiac transplantation. J Thorac Cardiovasc Surg 1992, 103: 33-39.PubMed
36.
Zurück zum Zitat Ricciardi MJ, Knight BP, Martinez FJ, Rubenfire M: Inhaled nitric oxide in primary pulmonary hypertension: a safe and effective agent for predicting response to nifedipine. J Am Coll Cardiol 1998, 32: 1068-1073. 10.1016/S0735-1097(98)00361-1CrossRefPubMed Ricciardi MJ, Knight BP, Martinez FJ, Rubenfire M: Inhaled nitric oxide in primary pulmonary hypertension: a safe and effective agent for predicting response to nifedipine. J Am Coll Cardiol 1998, 32: 1068-1073. 10.1016/S0735-1097(98)00361-1CrossRefPubMed
37.
Zurück zum Zitat Bhorade S, Christenson J, O'Connor M, Lavoie A, Pohlman A, Hall JB: Response to inhaled nitric oxide in patients with acute right heart syndrome. Am J Respir Crit Care Med 1999, 159: 571-579.CrossRefPubMed Bhorade S, Christenson J, O'Connor M, Lavoie A, Pohlman A, Hall JB: Response to inhaled nitric oxide in patients with acute right heart syndrome. Am J Respir Crit Care Med 1999, 159: 571-579.CrossRefPubMed
38.
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: 1443-1449.CrossRefPubMed 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: 1443-1449.CrossRefPubMed
39.
Zurück zum Zitat Semigran MJ, Cockrill BA, Kacmarek R, Thompson BT, Zapol WM, Dec GW, Fifer MA: Hemodynamic effects of inhaled nitric oxide in heart failure. J Am Coll Cardiol 1994, 24: 982-988.CrossRefPubMed Semigran MJ, Cockrill BA, Kacmarek R, Thompson BT, Zapol WM, Dec GW, Fifer MA: Hemodynamic effects of inhaled nitric oxide in heart failure. J Am Coll Cardiol 1994, 24: 982-988.CrossRefPubMed
40.
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: 2780-2755.CrossRefPubMed 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: 2780-2755.CrossRefPubMed
41.
Zurück zum Zitat McLaughlin VV, Genthner DE, Panella MM, Rich S: Reduction in pulmonary vascular resistance with long-term epoprostenol (prostacyclin) therapy in primary pulmonary hypertension. N Engl J Med 1998, 338: 273-277. 10.1056/NEJM199801293380501CrossRefPubMed McLaughlin VV, Genthner DE, Panella MM, Rich S: Reduction in pulmonary vascular resistance with long-term epoprostenol (prostacyclin) therapy in primary pulmonary hypertension. N Engl J Med 1998, 338: 273-277. 10.1056/NEJM199801293380501CrossRefPubMed
42.
Zurück zum Zitat Simonneau G, Barst RJ, Galie N, Naeije R, Rich S, Bourge RC, Keogh A, Oudiz R, Frost A, Blackburn SD, et al.: Continuous subcutaneous infusion of treprostinil, a prostacyclin analogue, in patients with pulmonary arterial hypertension: a double blind, randomized, placebo-controlled trial. Am J Respir Crit Care Med 2002, 165: 800-804.CrossRefPubMed Simonneau G, Barst RJ, Galie N, Naeije R, Rich S, Bourge RC, Keogh A, Oudiz R, Frost A, Blackburn SD, et al.: Continuous subcutaneous infusion of treprostinil, a prostacyclin analogue, in patients with pulmonary arterial hypertension: a double blind, randomized, placebo-controlled trial. Am J Respir Crit Care Med 2002, 165: 800-804.CrossRefPubMed
43.
Zurück zum Zitat Channick RN, Simonneau G, Sitbon O, Robbins IM, Frost A, Tapson VF, Badesch DB, Roux S, Rainisio M, Bodin F, et al.: Effects of the dual endothelin-receptor antagonist bosentan in patients with pulmonary hypertension: a randomized placebo-controlled study. Lancet 2001, 358: 1119-1123. 10.1016/S0140-6736(01)06250-XCrossRefPubMed Channick RN, Simonneau G, Sitbon O, Robbins IM, Frost A, Tapson VF, Badesch DB, Roux S, Rainisio M, Bodin F, et al.: Effects of the dual endothelin-receptor antagonist bosentan in patients with pulmonary hypertension: a randomized placebo-controlled study. Lancet 2001, 358: 1119-1123. 10.1016/S0140-6736(01)06250-XCrossRefPubMed
44.
Zurück zum Zitat Mychaskiw G, Sachdev V, Heath BJ: Sildenafil (Viagra) facilitates weaning of inhaled nitric oxide following placement of a biventricular-assist device. J Clin Anesth 2001, 13: 218-220. 10.1016/S0952-8180(01)00252-5CrossRefPubMed Mychaskiw G, Sachdev V, Heath BJ: Sildenafil (Viagra) facilitates weaning of inhaled nitric oxide following placement of a biventricular-assist device. J Clin Anesth 2001, 13: 218-220. 10.1016/S0952-8180(01)00252-5CrossRefPubMed
45.
Zurück zum Zitat Ghofrani HA, Wiedemann R, Rose F, Schermuly RT, Olschewski H, Weissmann N, Gunther A, Walmrath D, Seeger W, Grimminger F: Sildenafil for treatment of lung fibrosis and pulmonary hypertension: a randomised controlled trial. Lancet 2002, 360: 895-900. 10.1016/S0140-6736(02)11024-5CrossRefPubMed Ghofrani HA, Wiedemann R, Rose F, Schermuly RT, Olschewski H, Weissmann N, Gunther A, Walmrath D, Seeger W, Grimminger F: Sildenafil for treatment of lung fibrosis and pulmonary hypertension: a randomised controlled trial. Lancet 2002, 360: 895-900. 10.1016/S0140-6736(02)11024-5CrossRefPubMed
46.
Zurück zum Zitat Preston IR, Klinger JRJ, Houtches J, Nelson D, Farber HW, Hill NS: Acute and chronic effects of sildenafil in patients with pulmonary arterial hypertension. Respir Med 2006, in press. Preston IR, Klinger JRJ, Houtches J, Nelson D, Farber HW, Hill NS: Acute and chronic effects of sildenafil in patients with pulmonary arterial hypertension. Respir Med 2006, in press.
47.
Zurück zum Zitat Kaheinen P, Pollesello P, Levijoki J, Haikala H: Effects of levosimendan and milrinone on oxygen consumption in isolated giunea-pig. J Cardiovasc Pharmacol 2004, 43: 555-561. 10.1097/00005344-200404000-00011CrossRefPubMed Kaheinen P, Pollesello P, Levijoki J, Haikala H: Effects of levosimendan and milrinone on oxygen consumption in isolated giunea-pig. J Cardiovasc Pharmacol 2004, 43: 555-561. 10.1097/00005344-200404000-00011CrossRefPubMed
48.
Zurück zum Zitat Cleland JG, Takala A, Apajasalo M, Zethraeus N, Kobelt G: Intravenous levosimendan treatment is cost effective compared with dobutamine in severe low-output heart failure: an analysis based on the international LIDO trial. Eur J Heart Fail 2003, 5: 101-108. 10.1016/S1388-9842(02)00246-5CrossRefPubMed Cleland JG, Takala A, Apajasalo M, Zethraeus N, Kobelt G: Intravenous levosimendan treatment is cost effective compared with dobutamine in severe low-output heart failure: an analysis based on the international LIDO trial. Eur J Heart Fail 2003, 5: 101-108. 10.1016/S1388-9842(02)00246-5CrossRefPubMed
49.
Zurück zum Zitat Kivikko M, Lehtonen L: Levosimendan: a new inodilator drug for the treatment of decompensated heart failure. Curr Pharm Des 2005, 11: 435-455. 10.2174/1381612053382043CrossRefPubMed Kivikko M, Lehtonen L: Levosimendan: a new inodilator drug for the treatment of decompensated heart failure. Curr Pharm Des 2005, 11: 435-455. 10.2174/1381612053382043CrossRefPubMed
50.
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: 132-135. 10.1097/00000542-198402000-00009CrossRefPubMed 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: 132-135. 10.1097/00000542-198402000-00009CrossRefPubMed
51.
Zurück zum Zitat Kerbaul F, Rondelet B, Motte S, Fesler P, Hubloue I, Ewalenko P, Naeije R, Brimioulle S: Effects of norepinephrine and dobutamine on pressure load-induced right ventricular failure. Crit Care Med 2004, 32: 1035-1040. 10.1097/01.CCM.0000120052.77953.07CrossRefPubMed Kerbaul F, Rondelet B, Motte S, Fesler P, Hubloue I, Ewalenko P, Naeije R, Brimioulle S: Effects of norepinephrine and dobutamine on pressure load-induced right ventricular failure. Crit Care Med 2004, 32: 1035-1040. 10.1097/01.CCM.0000120052.77953.07CrossRefPubMed
52.
Zurück zum Zitat Greyson C, Xu Y, Cohen J, Schwartz GG: Right ventricular dysfunction persists following brief right ventricular pressure overload. Cardiovasc Res 1997, 34: 281-288. 10.1016/S0008-6363(97)00038-2CrossRefPubMed Greyson C, Xu Y, Cohen J, Schwartz GG: Right ventricular dysfunction persists following brief right ventricular pressure overload. Cardiovasc Res 1997, 34: 281-288. 10.1016/S0008-6363(97)00038-2CrossRefPubMed
Metadaten
Titel
What role does the right side of the heart play in circulation?
verfasst von
Maurizio Cecconi
Edward Johnston
Andrew Rhodes
Publikationsdatum
01.06.2006
Verlag
BioMed Central
Erschienen in
Critical Care / Ausgabe Sonderheft 3/2006
Elektronische ISSN: 1364-8535
DOI
https://doi.org/10.1186/cc4832

Weitere Artikel der Sonderheft 3/2006

Critical Care 3/2006 Zur Ausgabe

Bei schweren Reaktionen auf Insektenstiche empfiehlt sich eine spezifische Immuntherapie

Insektenstiche sind bei Erwachsenen die häufigsten Auslöser einer Anaphylaxie. Einen wirksamen Schutz vor schweren anaphylaktischen Reaktionen bietet die allergenspezifische Immuntherapie. Jedoch kommt sie noch viel zu selten zum Einsatz.

Hinter dieser Appendizitis steckte ein Erreger

23.04.2024 Appendizitis Nachrichten

Schmerzen im Unterbauch, aber sonst nicht viel, was auf eine Appendizitis hindeutete: Ein junger Mann hatte Glück, dass trotzdem eine Laparoskopie mit Appendektomie durchgeführt und der Wurmfortsatz histologisch untersucht wurde.

Ärztliche Empathie hilft gegen Rückenschmerzen

23.04.2024 Leitsymptom Rückenschmerzen Nachrichten

Personen mit chronischen Rückenschmerzen, die von einfühlsamen Ärzten und Ärztinnen betreut werden, berichten über weniger Beschwerden und eine bessere Lebensqualität.

Mehr Schaden als Nutzen durch präoperatives Aussetzen von GLP-1-Agonisten?

23.04.2024 Operationsvorbereitung Nachrichten

Derzeit wird empfohlen, eine Therapie mit GLP-1-Rezeptoragonisten präoperativ zu unterbrechen. Eine neue Studie nährt jedoch Zweifel an der Notwendigkeit der Maßnahme.

Update AINS

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