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Right Ventricular Failure 

Right Ventricular Failure
Chapter:
Right Ventricular Failure
Author(s):

John W. Kreit

DOI:
10.1093/med/9780190670085.003.0014
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date: 23 August 2019

Right ventricular (RV) failure is common in the ICU. Chronic RV failure is most often due to long-standing left ventricular (LV) systolic or diastolic failure or other causes of chronic pulmonary hypertension. Acute RV failure can result from massive pulmonary embolism, ARDS, RV infarction, and acute LV failure. Finally, acute-on-chronic RV failure can be precipitated by any disorder that leads to an abrupt rise in pulmonary vascular resistance (PVR) and RV afterload. Right Ventricular Failure provides an in-depth review of the adverse hemodynamic effects of mechanical ventilation and PEEP in patients with right ventricular failure. The chapter explains the effect of positive pressure ventilation and PEEP on pulmonary vascular resistance and RV afterload and describes how to adjust the ventilator to minimize these hemodynamic effects.

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