Pharmacological Interventions in Acute Respiratory Failure
The potential contribution of right ventricular (RV) dysfunction to acute cardiovascular failure has been increasingly recognized in recent years. Undoubtedly, the availability of more reliable methods of investigation has facilitated the recognition of RV dysfunction. As developed in other chapters, RV failure in acute respiratory insufficiency is principally due to increased afterload caused by pulmonary hypertension. When the right ventricle fails, RV size tends to enlarge to maintain stroke volume by increasing RV preload, but this compensatory mechanism can become insufficient and even deleterious in terms of the myocardial oxygen/supply relationship. Pulmonary hypertension can be associated with decreased RV contractility which is probably due to RV subendocardial ischemia . Since acute conditions are characterized by elevated tissue oxygen needs requiring a high oxygen transport, the pulmonary hypertension associated with respiratory failure is likely to contribute to morbidity and mortality in the critically ill [1, 2].
KeywordsIschemia Dopamine Serotonin Radionuclide Cardiol
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