Right ventricular failure is extremely common among critically ill patients (e.g., affecting a quarter of patients with ARDS). Unfortunately, this is often overlooked in critical care curricula. We tend to spend lots of time focusing on pulmonary arterial hypertension (which is far more rare), thereby overlooking the everyday conundrum of right ventricular failure. It's called “the forgotten ventricle” for a reason.
The good news is that you often don't need to do anything exceedingly crazy for most of these patients (e.g., you don't need to float a Swan in a quarter of all ARDS patients). Some basic techniques to identify right ventricular failure and institute physiologically-based treatments will go a long way. Recognition and management of this problem can transform may failed resuscitations into success stories.
-
The IBCC chapter is located 👉 here.
- The podcast & comments are below.
Follow us on iTunes
- PulmCrit Blogitorial – Use of ECGs for management of (sub)massive PE - March 24, 2024
- PulmCrit Wee: Propofol induced eyelid opening apraxia – the struggle is real - March 20, 2024
- PulmCrit wee: Why I like central lines for GI bleed resuscitation - March 13, 2024
Amazing post!
Very helpful website .. waiting for RV Failure podcast
Good day
I personally excited with content of this IBCC
I just have one question regarding use of milrinone in right ventricular failure
It is an inotropic and dilator
Dont you think its better than epinephrine
Less tachyarrhythmia less casoconstriction
Can be given alone
No need for dobutamine
Thanks in advance
Awaiting your response
Good day
I just have a small addendum regarding your warning against fluid intake unless important reason
I believe the reason could be
Right ventricular Myocirdial indarction
Or any obstructive shock
U give cautiously 200 ml of fluids over an hour and watchful follow up with an Echo
What do u think ?
Kindly awaiting your response