• Hakeem Yusuff, Sanchit Chawla, Ryota Sato, Siddharth Dugar, Mansoor N Bangash, Marta Velia Antonini, Benjamin Shelley, Kamen Valchanov, Andrew Roscoe, Jeffrey Scott, Waqas Akhtar, Alex Rosenberg, Ioannis Dimarakis, Maziar Khorsandi, Vasileios Zochios, and for Protecting the Right Ventricle Network (PRORVnet).
• Department of Cardiothoracic Critical Care Medicine and ECMO Unit, Glenfield Hospital, University Hospitals of Leicester NHS Trust, Leicester, United Kingdom; Department of Respiratory Sciences, University of Leicester, Leicester, United Kingdom. Electronic address: hakeem.yusuff1@nhs.net.
• J. Cardiothorac. Vasc. Anesth. 2023 Nov 1; 37 (11): 231823262318-2326.

AbstractThe right ventricle (RV) is intricately linked in the clinical presentation of critical illness; however, the basis of this is not well-understood and has not been studied as extensively as the left ventricle. There has been an increased awareness of the need to understand how the RV is affected in different critical illness states. In addition, the increased use of point-of-care echocardiography in the critical care setting has allowed for earlier identification and monitoring of the RV in a patient who is critically ill. The first part of this review describes and characterizes the RV in different perioperative states. This second part of the review discusses and analyzes the complex pathophysiologic relationships between the RV and different critical care states. There is a lack of a universal RV injury definition because it represents a range of abnormal RV biomechanics and phenotypes. The term "RV injury" (RVI) has been used to describe a spectrum of presentations, which includes diastolic dysfunction (early injury), when the RV retains the ability to compensate, to RV failure (late or advanced injury). Understanding the mechanisms leading to functional 'uncoupling' between the RV and the pulmonary circulation may enable perioperative physicians, intensivists, and researchers to identify clinical phenotypes of RVI. This, consequently, may provide the opportunity to test RV-centric hypotheses and potentially individualize therapies.Crown Copyright © 2023. Published by Elsevier Inc. All rights reserved.

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