Tilea Ioan, Varga Andreea, Georgescu Anca-Meda, Grigorescu Bianca-Liana
George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, Targu Mures Romania.
Department of Cardiology II, Emergency Clinical County Hospital, Targu Mures, Romania.
J Crit Care Med (Targu Mures). 2021 Aug 5;7(3):170-183. doi: 10.2478/jccm-2021-0020. eCollection 2021 Jul.
Despite substantial advancements in diagnosis and specific medical therapy in pulmonary arterial hypertension patients' management, this condition continues to represent a major cause of mortality worldwide. In pulmonary arterial hypertension, the continuous increase of pulmonary vascular resistance and rapid development of right heart failure determine a poor prognosis. Against targeted therapy, patients inexorable deteriorate over time. Pulmonary arterial hypertension patients with acute right heart failure who need intensive care unit admission present a complexity of the disease pathophysiology. Intensive care management challenges are multifaceted. Awareness of algorithms of right-sided heart failure monitoring in intensive care units, targeted pulmonary hypertension therapies, and recognition of precipitating factors, hemodynamic instability and progressive multisystem organ failure requires a multidisciplinary pulmonary hypertension team. This paper summarizes the management strategies of acute right-sided heart failure in pulmonary arterial hypertension adult cases based on recently available data.
尽管在肺动脉高压患者的管理中，诊断和特异性药物治疗取得了重大进展，但这种疾病在全球范围内仍然是主要的死亡原因。在肺动脉高压中，肺血管阻力的持续增加和右心衰竭的快速发展决定了预后不良。面对靶向治疗，患者会随着时间的推移而不可避免地恶化。需要入住重症监护病房的急性右心衰竭肺动脉高压患者呈现出疾病病理生理学的复杂性。重症监护管理面临多方面挑战。要了解重症监护病房中右侧心力衰竭监测的算法、靶向肺动脉高压治疗，以及识别诱发因素、血流动力学不稳定和进行性多系统器官衰竭，需要一个多学科的肺动脉高压团队。本文基于最近可得的数据，总结了成年肺动脉高压患者急性右侧心力衰竭的管理策略。
