Related Experiment Video
Updated: Jun 13, 2026
08:51
Multiple Intravenous Bolus Dosing and Invasive Hemodynamic Assessment in a Hypoxia-Induced Mouse Pulmonary Artery Hypertension Model
Published on: November 11, 2022
Anesthesia for patients with pulmonary hypertension
Chad D Pritts1, Ronald G Pearl
1Stanford University, Stanford, California, USA.
Current Opinion in Anaesthesiology
|April 14, 2010
Summary
Optimizing therapy for pulmonary hypertension before surgery is crucial. Anesthetic management should focus on maintaining right ventricular function and avoiding low blood pressure to reduce high risks in these patients.
Area of Science:
- Cardiology
- Anesthesiology
- Pulmonary Medicine
Background:
- Patients with pulmonary hypertension face significant risks during anesthesia and surgery.
- Advances in understanding and treating pulmonary hypertension offer potential for improved outcomes.
Purpose of the Study:
- To review current understanding and therapeutic strategies for pulmonary hypertension in perioperative patients.
- To highlight key considerations for anesthetic management in this high-risk population.
Main Methods:
- Review of current literature on pulmonary hypertension classification, diagnosis, and perioperative management.
- Discussion of diagnostic tools like echocardiography and pulmonary artery catheterization.
- Evaluation of therapeutic interventions, including inhaled vasodilators.
Main Results:
- Pulmonary hypertension has diverse subtypes requiring tailored therapy.
- Echocardiography is vital but has limitations in pressure estimation.
- Inhaled vasodilators demonstrate effective and selective pulmonary vasodilation.
Conclusions:
- Defining the cause and optimizing therapy for pulmonary hypertension preoperatively is essential.
- Anesthetic goals include preserving right ventricular output and preventing systemic hypotension.
- Inhaled vasodilators can be critical in managing perioperative right heart failure due to pulmonary hypertension exacerbation.
Related Concept Videos
01:16Treatment for Pulmonary Arterial Hypertension: Oxygen Therapy for Respiratory Failure
Oxygen therapy has emerged as a significant tool in enhancing the quality of life for patients suffering from pulmonary arterial hypertension (PAH). While this therapy has principally been studied on patients with significant hypoxemia, this therapeutic approach helps prevent potential organ damage and can be administered in the comfort of one's home.
Oxygen therapy is vital in increasing and maintaining blood oxygen levels in PAH patients. As a result, it aids in reducing fatigue, improving...
Oxygen therapy is vital in increasing and maintaining blood oxygen levels in PAH patients. As a result, it aids in reducing fatigue, improving...
01:18Treatment for Pulmonary Arterial Hypertension: Endothelin Receptor Antagonists
Endothelins (ETs) are potent vasoactive peptides critical in the human body's various physiological and pathological processes. One of the most promising therapeutic strategies for treating pulmonary arterial hypertension (PAH) involves counteracting the effects of these endothelins using a class of drugs known as endothelin receptor antagonists.
ETs are synthesized through a complex sequence of enzymatic steps, primarily involving an enzyme referred to as endothelin-converting enzyme (ECE). Of...
ETs are synthesized through a complex sequence of enzymatic steps, primarily involving an enzyme referred to as endothelin-converting enzyme (ECE). Of...
01:30Pulmonary Hypertension: Classification and Pathogenesis
Pulmonary hypertension (PH) is a severe health condition in which the mean pulmonary arterial pressure increases to 25 mmHg or more, even when the body is at rest. This high pressure in the blood vessels that transport blood from the heart to the lungs can cause various symptoms, including shortness of breath, can lead to right heart failure, and significantly affect the overall quality of life.
There are various classifications for PH, each relating to different underlying causes and also...
There are various classifications for PH, each relating to different underlying causes and also...
01:23Treatment for Pulmonary Arterial Hypertension: Prostacyclin Receptor Agonists
Prostacyclin receptor agonists are a class of therapeutic agents integral to managing pulmonary arterial hypertension (PAH). These drugs operate by mimicking the action of prostaglandin I2, or PGI2, a naturally occurring compound in the body.
These agonists bind to the IPR receptor situated on the plasma membrane of the pulmonary artery smooth muscle cells. This binding triggers a cascade of reactions known as the GS-AC-cAMP-PKA pathway. This pathway results in the relaxation of smooth muscle...
These agonists bind to the IPR receptor situated on the plasma membrane of the pulmonary artery smooth muscle cells. This binding triggers a cascade of reactions known as the GS-AC-cAMP-PKA pathway. This pathway results in the relaxation of smooth muscle...
01:26Treatment for Pulmonary Arterial Hypertension: Receptor Tyrosine Kinase Inhibitors and Calcium Channel Blockers
Receptor tyrosine kinase inhibitors (TKIs) and calcium channel blockers (CCBs) are two critical categories of drugs employed in the treatment of pulmonary artery hypertension (PAH). PAH is a disease that causes high blood pressure in the pulmonary arteries, resulting in chest pain, fatigue, and shortness of breath.
TKIs, such as imatinib (Gleevec), are particularly effective in tackling the growth and mitogenic factors that become upregulated in PAH patients. These factors contribute to the...
TKIs, such as imatinib (Gleevec), are particularly effective in tackling the growth and mitogenic factors that become upregulated in PAH patients. These factors contribute to the...
01:20Inhalational Anesthetics: Overview
Inhalation anesthetics are drugs that induce general anesthesia upon inhalation. They work by increasing the sensitivity of GABAA receptors or inhibiting NMDA receptors, leading to a decrease in central nervous system activity. The depth of anesthesia can be rapidly adjusted by changing the concentration of the inhaled gas. Some common examples of inhalational anesthetics include volatile liquids like isoflurane, desflurane, sevoflurane and gases like xenon and nitrous oxide. Isoflurane, a...