Sommer N, Hecker M, Tello K, Richter M, Liebetrau C, Weigand M A, Seeger W, Ghofrani A, Gall H
Medizinische Klinik II, Universitätsklinikum Gießen und Marburg, Standort Gießen; Deutsches Zentrum für Lungenforschung (DZL), Klinikstr. 33, 35392, Gießen, Deutschland.
Abteilung für Pneumologie, Universitätsklinik Marburg, Baldingerstrasse, 35043, Marburg, Deutschland.
Anaesthesist. 2016 Aug;65(8):635-52. doi: 10.1007/s00101-016-0207-y.
Pulmonary hypertension (PH) comprises a group of pulmonary vascular diseases that are characterized by progressive exertional dyspnea and right heart insufficiency ultimately resulting in right heart decompensation. The classification is into five clinical subgroups that form the absolutely essential basis for decisions on the indications for different pharmacological and non-pharmacological forms of treatment. The guidelines were updated in 2015 and in addition to the hitherto existing pharmacological treatment options of phosphodiesterase type 5 inhibitors, endothelin receptor antagonists and prostacyclins, the soluble guanylate cyclase stimulator riociguat has now been incorporated for treatment of certain forms of PH. This article provides an overview of the new treatment recommendations in the current guidelines, e. g. for PH patients who are in intensive care units due to surgical interventions or progressive right heart insufficiency.
肺动脉高压(PH)是一组以进行性劳力性呼吸困难和右心功能不全为特征的肺血管疾病,最终可导致右心失代偿。其分类包括五个临床亚组,这构成了决定不同药物和非药物治疗形式适应证的绝对必要基础。该指南于2015年更新,除了此前现有的5型磷酸二酯酶抑制剂、内皮素受体拮抗剂和前列环素等药物治疗选择外,可溶性鸟苷酸环化酶刺激剂利奥西呱现已被纳入用于治疗某些类型的PH。本文概述了当前指南中的新治疗建议,例如针对因手术干预或进行性右心功能不全而入住重症监护病房的PH患者。