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Pulmonary Hypertension in ARDS: Management Strategies

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Abstract

Pulmonary hypertension (PH) is the consequence of either acute or chronic diseases resulting in the loss of the low pressure-high flow characteristics of pulmonary circulation. In 1977, Zapol and Snider demonstrated that PH is a physiological hallmark of ARDS as shown by the occurrence of a mean pulmonary arterial pressure (mPAP) > 25 mmHg in 58% of patients with severe ARF in the early phase [1]. In over 100 patients with ARDS, studied from 1–30 days after onset of symptoms, Zapol et al. observed mPAP to be around 22–28 mmHg in absence of severe hypoxemia, and in the range of 28–35 mmHg or more in presence of severe hypoxemia [2].

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References

  1. Zapol WM, Snider MT (1977) Pulmonary hypertension in severe acute respiratory failure. N Engl J Med 296: 476 - 480

    Article  PubMed  CAS  Google Scholar 

  2. Zapol WM, Snider MT, Rie MA et al (1986) Pulmonary circulation during adult pulmonary distress syndrome. In: Zapol WM, Falke KJ (eds) Acute respiratory failure. New York, Marcel Dekker, vol 24, pp 241 - 273

    Google Scholar 

  3. Jones R, Reid LM, Zapol WM et al (1992) Pulmonary vascular pathology: Human and experimental studies. In: Zapol WM, Falke KJ (eds) Lung biology in health and diseases. New York, Marcel Dekker, pp 23 - 160

    Google Scholar 

  4. Squara P, Dhainaut JF, Artigas A et al (1998) Hemodynamic profile in severe ARDS: results of the European Collaborative ARDS study. Int Care Med 24: 1018 - 1028

    Article  CAS  Google Scholar 

  5. Brienza A, Cinnella G, Dambrosio M et al (1991) Incidence of pulmonary arterial hypertension and right ventricular impairment in moderate and severe acute respiratory failure. Acta Anaesthesiologica Italica 42[Suppl 11: 45 - 55

    Google Scholar 

  6. Dambrosio M, Fiore G, Brienza N et al (1996) Right ventricular myocardial function in ARF patients. Int Care Med 22: 772 - 780

    Article  CAS  Google Scholar 

  7. Brunet F, Dhainaut JF, Devaux JY et al (1988) Right ventricular performance in patients with acute respiratory failure. Int Care Med 14: 474 - 477

    Article  Google Scholar 

  8. Abraham AS, Cole RB, Greene ID et al (1969) Factors contributing to the reversible pulmonary hypertension in patients with acute respiratory failure studied by serial observation during recovery. Cire Res 24: 51 - 60

    Article  CAS  Google Scholar 

  9. Melot CP, Lejeune M, Leeman JJ et al (1989) Prostaglandin E1 in the ARDS. Benefit for pulmonary hypertension and cost for pulmonary gas exchange. Am Rev Respir Dis 139: 106-116

    Google Scholar 

  10. Radermacher P, Santak B, Wust J et al (1990) Prostacyclin and right ventricular function in patients with pulmonary hypertension associated with ARDS. Int Care Med 16: 227 - 232

    Article  CAS  Google Scholar 

  11. Holcroft JW, Vossar MJ, Weber CJ (1986) Prostaglandin E1 and survival in patients with the adult distress syndrome. Ann Surg 203: 371 - 380

    Article  PubMed  CAS  Google Scholar 

  12. Bone RC, Slotman G, Maunder R et al (1989) Randomized double-blind multi-centre study of prostaglandin E1 in patients with the adult respiratory distress syndrome. Chest 96: 114 - 119

    Article  PubMed  CAS  Google Scholar 

  13. Brienza N (1998) Inhaled prostacyclin: from pulmonary hypertension to splanchnic hypoperfusion. Int Care Med 24: 1228 - 1230

    Article  CAS  Google Scholar 

  14. Ferreira E, Shalansky SJ (1999) Nitric oxide for ARDS - what is the evidence? Pharmacotherapy 19: 60 - 69

    Article  PubMed  CAS  Google Scholar 

  15. Mikhail G, Gibbs JSR, Richardson M et al (1997) An evaluation of nebulized prostacyclin in patients with primary and secondary pulmonary hypertension. Eur Heart J 18: 1499 - 1504

    Article  PubMed  CAS  Google Scholar 

  16. Zwissler B, Kemming G, Habler O et al (1996) Inhaled prostacyclin (PGI2) versus inhaled nitric oxide in Adult Respiratory Distress Syndrome. Am J Respir Crit Care Med 154: 1671 - 1677

    PubMed  CAS  Google Scholar 

  17. Walmrath D, Schneider T, Schermuly R et al (1996) Direct comparison of inhaled nitric oxide and aerosolized prostacyclin in Acute Respiratory Distress Syndrome. Am J Respir Crit Care Med 153: 991 - 996

    PubMed  CAS  Google Scholar 

  18. Brienza N, Grasso S, Bruno F et al (1996) Effects of continuous administration of aerosolized prostacyclin on hemodynamics and gas exchange in ARDS. Int Care Med 22 (3): S427

    Google Scholar 

  19. Rossaint R, Slama K, Steudel Wet al (1995) Effects of inhaled nitric oxide on right ventricular function in severe acute respiratory distress syndrome. Int Care Med 21: 197 - 203

    Article  CAS  Google Scholar 

  20. Zwissler B, Welte M, Messmer K (1995) Effects of inhaled prostacyclin as compared with inhaled nitric oxide on right ventricular performance in hypoxic pulmonary vasoconstriction. J Cardiothor Vasc Anesth 9 (3): 283 - 289

    Article  CAS  Google Scholar 

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© 2000 Springer-Verlag Italia

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Brienza, A., Brienza, N. (2000). Pulmonary Hypertension in ARDS: Management Strategies. In: Gullo, A. (eds) Anesthesia, Pain, Intensive Care and Emergency Medicine — A.P.I.C.E.. Springer, Milano. https://doi.org/10.1007/978-88-470-2286-7_5

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  • DOI: https://doi.org/10.1007/978-88-470-2286-7_5

  • Publisher Name: Springer, Milano

  • Print ISBN: 978-88-470-0095-7

  • Online ISBN: 978-88-470-2286-7

  • eBook Packages: Springer Book Archive

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