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.
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