Management of Right Heart Failure in the Intensive Care Unit

Clin Chest Med. 2015 Sep;36(3):511-20. doi: 10.1016/j.ccm.2015.05.015. Epub 2015 Jun 27.

Abstract

Right heart failure is a clinical syndrome of various causes that commonly involves failure of the right ventricle (RV). The hemodynamic hallmark of the syndrome is increasing central venous pressure and worsening cardiac output with a rising RV end-diastolic pressure. When dealing with RV failure, clinicians must assess and optimize the intravascular volume state, support RV contractility, and address any pathologic elevations of afterload so that systemic perfusion is preserved. Despite these measures, there may still be a need to offer rescue interventions to the failing RV in carefully selected patients.

Keywords: Atrial septostomy; Potts shunt; Pulmonary arterial hypertension (PAH); Pulmonary hypertension (PH); Pulmonary vasodilators; Right heart failure (RHF); Right ventricular failure (RVF).

Publication types

  • Review

MeSH terms

  • Disease Management*
  • Heart Failure / therapy*
  • Heart Ventricles / abnormalities*
  • Humans
  • Hypertension, Pulmonary / etiology
  • Intensive Care Units*
  • Ventricular Dysfunction, Right / therapy*