Pulmonary Vasodilators and Anesthesia Considerations

Pulmonary hypertension (PH) is a complex disease process of the pulmonary vasculature system characterized by elevated pulmonary arterial pressures. Patients with PH are at increased risk for morbidity and mortality, including intraoperatively and postoperatively. Appreciation by the clinical anesth...

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Bibliographic Details
Published inAnesthesiology clinics Vol. 35; no. 2; p. 221
Main Authors Green, Jeremy B, Hart, Brendon, Cornett, Elyse M, Kaye, Alan D, Salehi, Ali, Fox, Charles J
Format Journal Article
LanguageEnglish
Published United States 01.06.2017
Subjects
Anesthesia
Humans
Hypertension, Pulmonary - drug therapy
Hypertension, Pulmonary - etiology
Muscle, Smooth, Vascular - drug effects
Muscle, Smooth, Vascular - physiology
Nitric Oxide - administration & dosage
Pulmonary Circulation - drug effects
Pulmonary Circulation - physiology
Vascular Resistance - drug effects
Vascular Resistance - physiology
Vasodilator Agents - therapeutic use
Anesthesia
Prostacyclin
Calcium channel blockers
Inhaled nitric oxide
Pulmonary hypertension
Endothelin antagonists
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Summary:Pulmonary hypertension (PH) is a complex disease process of the pulmonary vasculature system characterized by elevated pulmonary arterial pressures. Patients with PH are at increased risk for morbidity and mortality, including intraoperatively and postoperatively. Appreciation by the clinical anesthesiologist of the pathophysiology of PH is warranted. Careful and meticulous strategy using appropriate anesthetic medications, pulmonary vasodilator and inotropic agents, and careful fluid management all increase the likelihood of the best possible outcome in this challenging patient population.
ISSN:1932-2275
DOI:10.1016/j.anclin.2017.01.008