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Intensive care, right ventricular support and lung transplantation in patients with pulmonary hypertension
Intensive care of patients with pulmonary hypertension (PH) and right-sided heart failure includes treatment of factors causing or contributing to heart failure, careful fluid management, and strategies to reduce ventricular afterload and improve cardiac function. Extracorporeal membrane oxygenation...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
European Respiratory Society
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6351385/ https://www.ncbi.nlm.nih.gov/pubmed/30545979 http://dx.doi.org/10.1183/13993003.01906-2018 |
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author | Hoeper, Marius M. Benza, Raymond L. Corris, Paul de Perrot, Marc Fadel, Elie Keogh, Anne M. Kühn, Christian Savale, Laurent Klepetko, Walter |
author_facet | Hoeper, Marius M. Benza, Raymond L. Corris, Paul de Perrot, Marc Fadel, Elie Keogh, Anne M. Kühn, Christian Savale, Laurent Klepetko, Walter |
author_sort | Hoeper, Marius M. |
collection | PubMed |
description | Intensive care of patients with pulmonary hypertension (PH) and right-sided heart failure includes treatment of factors causing or contributing to heart failure, careful fluid management, and strategies to reduce ventricular afterload and improve cardiac function. Extracorporeal membrane oxygenation (ECMO) should be considered in distinct situations, especially in candidates for lung transplantation (bridge to transplant) or, occasionally, in patients with a reversible cause of right-sided heart failure (bridge to recovery). ECMO should not be used in patients with end-stage disease without a realistic chance for recovery or for transplantation. For patients with refractory disease, lung transplantation remains an important treatment option. Patients should be referred to a transplant centre when they remain in an intermediate- or high-risk category despite receiving optimised pulmonary arterial hypertension therapy. Meticulous peri-operative management including the intra-operative and post-operative use of ECMO effectively prevents graft failure. In experienced centres, the 1-year survival rates after lung transplantation for PH now exceed 90%. |
format | Online Article Text |
id | pubmed-6351385 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | European Respiratory Society |
record_format | MEDLINE/PubMed |
spelling | pubmed-63513852019-02-06 Intensive care, right ventricular support and lung transplantation in patients with pulmonary hypertension Hoeper, Marius M. Benza, Raymond L. Corris, Paul de Perrot, Marc Fadel, Elie Keogh, Anne M. Kühn, Christian Savale, Laurent Klepetko, Walter Eur Respir J Series Intensive care of patients with pulmonary hypertension (PH) and right-sided heart failure includes treatment of factors causing or contributing to heart failure, careful fluid management, and strategies to reduce ventricular afterload and improve cardiac function. Extracorporeal membrane oxygenation (ECMO) should be considered in distinct situations, especially in candidates for lung transplantation (bridge to transplant) or, occasionally, in patients with a reversible cause of right-sided heart failure (bridge to recovery). ECMO should not be used in patients with end-stage disease without a realistic chance for recovery or for transplantation. For patients with refractory disease, lung transplantation remains an important treatment option. Patients should be referred to a transplant centre when they remain in an intermediate- or high-risk category despite receiving optimised pulmonary arterial hypertension therapy. Meticulous peri-operative management including the intra-operative and post-operative use of ECMO effectively prevents graft failure. In experienced centres, the 1-year survival rates after lung transplantation for PH now exceed 90%. European Respiratory Society 2019-01-24 /pmc/articles/PMC6351385/ /pubmed/30545979 http://dx.doi.org/10.1183/13993003.01906-2018 Text en Copyright ©ERS 2019 http://creativecommons.org/licenses/by-nc/4.0/ This article is open access and distributed under the terms of the Creative Commons Attribution Non-Commercial Licence 4.0. |
spellingShingle | Series Hoeper, Marius M. Benza, Raymond L. Corris, Paul de Perrot, Marc Fadel, Elie Keogh, Anne M. Kühn, Christian Savale, Laurent Klepetko, Walter Intensive care, right ventricular support and lung transplantation in patients with pulmonary hypertension |
title | Intensive care, right ventricular support and lung transplantation in patients with pulmonary hypertension |
title_full | Intensive care, right ventricular support and lung transplantation in patients with pulmonary hypertension |
title_fullStr | Intensive care, right ventricular support and lung transplantation in patients with pulmonary hypertension |
title_full_unstemmed | Intensive care, right ventricular support and lung transplantation in patients with pulmonary hypertension |
title_short | Intensive care, right ventricular support and lung transplantation in patients with pulmonary hypertension |
title_sort | intensive care, right ventricular support and lung transplantation in patients with pulmonary hypertension |
topic | Series |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6351385/ https://www.ncbi.nlm.nih.gov/pubmed/30545979 http://dx.doi.org/10.1183/13993003.01906-2018 |
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