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Published on: November 26, 2018
Optimizing Mechanical Ventilation in Right Heart Failure
Angela Phillips1, Gustavo A Cortes-Puentes1
1Division of Pulmonary and Critical Care Medicine, Mayo Clinic, 200 First Street Southwest, Rochester, MN 55905, USA.
Abstract:
In patients with acute respiratory distress syndrome, the prevalence of right ventricular dysfunction (RVD) has been documented as high as 60%, though more recent estimates suggest a lower incidence of 20% to 30%, potentially reflecting the broader implementation of lung-protective ventilation strategies. The objective of this article is to review the physiologic principles of mechanical ventilation considering the unique challenges posed by RVD, and to offer a practical bedside approach to optimizing ventilatory support in this patient population. Importantly, mechanical ventilation strategies should aim to protect both the lungs and the heart-in all critically ill patients requiring ventilatory support.
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