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Mechanical Ventilation in Patients with Pulmonary HTN
- In the critically ill patient with pulmonary HTN and respiratory failure, improper mechanical ventilator settings can be disastrous.
- Large lung volumes and high levels of PEEP can result in acute cardiovascular collapse.
- When setting the ventilator is these patients, select low tidal volumes and relatively low levels of PEEP (3-5 cm H2O).
- In addition, small studies suggest avoiding permissive hypercapnia, as this may increase pulmonary vascular resistance and mean pulmonary arterial pressure.
References
- Zamanian RT, et al. Management strategies for patients with pulmonary hypertension in the intensive care unit. Crit Care Med 2007; 35:2037-50.
- Gayat E, et al. Pulmonary hypertension in critical care. Curr Opin Crit Care 2011; 17:439-448.