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Management of right ventricular dysfunction in the perioperative setting
Alexander Zarbock1, Hugo Van Aken, Christoph Schmidt
1Department of Anesthesiology, Intensive Care and Pain Medicine, University of Münster, Munster, Germany.
Current Opinion in Anaesthesiology
|May 21, 2014
Summary
Acute right ventricular failure is a serious perioperative complication. Correcting reversible causes and using targeted therapies like diuretics or inotropes can improve outcomes in patients with right ventricular dysfunction.
Area of Science:
- Cardiology
- Critical Care Medicine
- Anesthesiology
Background:
- Acute right ventricular dysfunction and failure are common in the perioperative setting.
- This condition significantly increases patient mortality.
- It stems from reduced contractility or increased afterload of the right ventricle.
Purpose of the Study:
- To review the approach to and recent advancements in managing acute right ventricular dysfunction and failure during the perioperative period.
- To highlight the challenges and current therapeutic strategies.
Main Methods:
- This is a review article summarizing existing literature and recent research.
- It focuses on the pathophysiology, diagnosis, and treatment of perioperative right ventricular failure.
Main Results:
- Management remains challenging due to limited understanding, diagnostic difficulties, and few guidelines.
- Recent research has improved understanding of mechanisms and established a therapeutic framework.
- Right ventricular dysfunction can lead to venous congestion and systemic hypoperfusion.
Conclusions:
- The primary goal is to address reversible causes of right ventricular dysfunction.
- Therapeutic options include diuretics, vasodilators, and inotropic agents when underlying issues cannot be reversed.