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Critical care clinics · Jul 2020
ReviewManagement of Right Ventricular Failure in Pulmonary Embolism.
- Steven Zhao and Oren Friedman.
- Division of Pulmonary and Critical Care medicine, Cedars-Sinai Medical Center, 8700 Beverly Boulevard, Room 6728, Los Angeles, CA 90048, USA.
- Crit Care Clin. 2020 Jul 1; 36 (3): 505-515.
AbstractAcute right ventricular failure remains the leading cause of mortality associated with acute pulmonary embolism (PE). This article reviews the pathophysiology behind acute right ventricular failure and strategies for managing right ventricular failure in acute PE. Immediate clot reduction via systemic thrombolytics, catheter based procedures, or surgery is always advocated for unstable patients. While waiting to mobilize these resources, it often becomes necessary to support the RV with vasoactive medications. Clinicians should carefully assess volume status and use caution with volume resuscitation. Right ventricular assist devices may have an expanding role in the future.Copyright © 2020 Elsevier Inc. All rights reserved.
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