Pulmonary hypertension in intensive care: pathophysiology and causes

Pulmonary hypertension is commonly encountered in Intensive Care Units and the effects on right ventricular function are often a cause for concern. The major thrust of treatment must, in the first instance, be aimed at the condition causing the hypertension. Treatment with vasodilator drugs may result in systemic hypotension which may impair coronary blood flow to the right ventricle, and may also result in an impairment of gas exchange. The inhalation of nitric oxide is an interesting new approach to treatment, but its value has not yet been evaluated in randomized controlled trials.