Scholarlink

<p>The occurrence of right heart failure is associated with a high mortality in critically ill patients, regardless of the underlying disease. The diagnostics are still a&#xa0;major clinical challenge. This article aims to provide an overview of the etiology, pathogenesis, diagnostic methods and management of patients with right heart failure on the intensive care unit. Echocardiography and invasive catheter techniques are the most frequently used examination methods. In the presence of a relevant right heart dysfunction or right heart failure, the focus should lie on the optimization of the preload or afterload as well as improvement of the contractility and elimination of reversible problems. There are patient groups with an increased risk of developing right ventricular (RV) dysfunction during a critical illness, especially patients with acute respiratory distress syndrome (ARDS). These patients should be regularly screened for the presence of a RV dysfunction and treated. Additionally, for all ventilated patients and particularly in ARDS the focus must also be on the optimization of ventilation with the aim of relieving the RV and the consistent use of prone positioning. An attempt can be made to pharmaceutically reduce the pulmonary pressure by interfering with various signaling pathways. As a&#xa0;last resort, mechanical support systems such as extracorporeal membrane oxygenation (ECMO) or right ventricular assist devices (RVAD) can be used after conservative treatment options have been exhausted.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Management des dekompensierten rechten Herzens auf der Intensivstation

  • 期刊论文

  • 发表日期：

    2025年1月15日

查看全文
  • Jeannine L. Kühnle,
  • Philipp M. Lepper

摘要

The occurrence of right heart failure is associated with a high mortality in critically ill patients, regardless of the underlying disease. The diagnostics are still a major clinical challenge. This article aims to provide an overview of the etiology, pathogenesis, diagnostic methods and management of patients with right heart failure on the intensive care unit. Echocardiography and invasive catheter techniques are the most frequently used examination methods. In the presence of a relevant right heart dysfunction or right heart failure, the focus should lie on the optimization of the preload or afterload as well as improvement of the contractility and elimination of reversible problems. There are patient groups with an increased risk of developing right ventricular (RV) dysfunction during a critical illness, especially patients with acute respiratory distress syndrome (ARDS). These patients should be regularly screened for the presence of a RV dysfunction and treated. Additionally, for all ventilated patients and particularly in ARDS the focus must also be on the optimization of ventilation with the aim of relieving the RV and the consistent use of prone positioning. An attempt can be made to pharmaceutically reduce the pulmonary pressure by interfering with various signaling pathways. As a last resort, mechanical support systems such as extracorporeal membrane oxygenation (ECMO) or right ventricular assist devices (RVAD) can be used after conservative treatment options have been exhausted.