- Section 1 ICU organization and management
- Section 2 Pharmacotherapeutics
- Section 3 Resuscitation
- Section 4 The respiratory system
- Section 5 The cardiovascular system
- Part 5.1 Physiology
- Part 5.2 Cardiovascular monitoring
- Chapter 129 ECG monitoring in the ICU
- Chapter 130 Arterial and venous cannulation in the ICU
- Chapter 131 Blood pressure monitoring in the ICU
- Chapter 132 Central venous pressure monitoring in the ICU
- Chapter 133 Pulmonary artery catheterization in the ICU
- Chapter 134 Mixed and central venous oxygen saturation monitoring in the ICU
- Chapter 135 Right ventricular function in the ICU
- Chapter 136 Cardiac output assessment in the ICU
- Chapter 137 Oxygen transport in the critically ill
- Chapter 138 Tissue perfusion monitoring in the ICU
- Chapter 139 Lactate monitoring in the ICU
- Chapter 140 Measurement of extravascular lung water in the ICU
- Chapter 141 Doppler echocardiography in the ICU
- Chapter 142 Monitoring the microcirculation in the ICU
- Chapter 143 Imaging the cardiovascular system in the ICU
- Part 5.3 Acute chest pain and coronary syndromes
- Part 5.4 Aortic dissection
- Part 5.5 The hypotensive patient
- Part 5.6 Cardiac failure
- Part 5.7 Tachyarrhythmias
- Part 5.8 Bradyarrhythmias
- Part 5.9 Valvular problems
- Part 5.10 Endocarditis
- Part 5.11 Severe hypertension
- Part 5.12 Severe capillary leak
- Part 5.13 Pericardial tamponade
- Part 5.14 Pulmonary hypertension
- Part 5.15 Pulmonary embolus
- Section 6 The gastrointestinal system
- Section 7 Nutrition
- Section 8 The renal system
- Section 9 The neurological system
- Section 10 The metabolic and endocrine systems
- Section 11 The haematological system
- Section 12 The skin and connective tissue
- Section 13 Infection
- Section 14 Inflammation
- Section 15 Poisoning
- Section 16 Trauma
- Section 17 Physical disorders
- Section 18 Pain and sedation
- Section 19 General surgical and obstetric intensive care
- Section 20 Specialized intensive care
- Section 21 Recovery from critical illness
- Section 22 End-of-life care
Right ventricular function in the ICU
- Chapter:
- Right ventricular function in the ICU
- Author(s):
Antoine Vieillard-Baron
- DOI:
- 10.1093/med/9780199600830.003.0135
Under normal conditions, the right ventricle (RV) virtually acts as a passive conduit. In critically-ill patients many situations induce uncoupling between the right ventricle and pulmonary circulation, leading to RV systolic dysfunction, then failure. Mechanical ventilation has a major impact by decreasing RV preload, but also significantly increasing RV afterload. RV function should thus always be interpreted and re-evaluated in the light of respiratory mechanics and ventilator settings. RV systolic function is key to the patient’s haemodynamic profile and must be monitored to achieve optimal haemodynamic management. Echocardiography is the best compromise between clinical effectiveness and invasiveness to monitor RV function. A limitation is its inability to monitor haemodynamics continuously. Acute cor pulmonale is defined by the combination of RV dilatation with paradoxical septal motion during systole. In conclusion, RV function monitoring is strongly recommended in many situations encountered in the intensive care unit, such as ARDS, septic shock, and pulmonary embolism. Many devices are available, but echocardiography constitutes the best compromise between accuracy and invasiveness.
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- Section 1 ICU organization and management
- Section 2 Pharmacotherapeutics
- Section 3 Resuscitation
- Section 4 The respiratory system
- Section 5 The cardiovascular system
- Part 5.1 Physiology
- Part 5.2 Cardiovascular monitoring
- Chapter 129 ECG monitoring in the ICU
- Chapter 130 Arterial and venous cannulation in the ICU
- Chapter 131 Blood pressure monitoring in the ICU
- Chapter 132 Central venous pressure monitoring in the ICU
- Chapter 133 Pulmonary artery catheterization in the ICU
- Chapter 134 Mixed and central venous oxygen saturation monitoring in the ICU
- Chapter 135 Right ventricular function in the ICU
- Chapter 136 Cardiac output assessment in the ICU
- Chapter 137 Oxygen transport in the critically ill
- Chapter 138 Tissue perfusion monitoring in the ICU
- Chapter 139 Lactate monitoring in the ICU
- Chapter 140 Measurement of extravascular lung water in the ICU
- Chapter 141 Doppler echocardiography in the ICU
- Chapter 142 Monitoring the microcirculation in the ICU
- Chapter 143 Imaging the cardiovascular system in the ICU
- Part 5.3 Acute chest pain and coronary syndromes
- Part 5.4 Aortic dissection
- Part 5.5 The hypotensive patient
- Part 5.6 Cardiac failure
- Part 5.7 Tachyarrhythmias
- Part 5.8 Bradyarrhythmias
- Part 5.9 Valvular problems
- Part 5.10 Endocarditis
- Part 5.11 Severe hypertension
- Part 5.12 Severe capillary leak
- Part 5.13 Pericardial tamponade
- Part 5.14 Pulmonary hypertension
- Part 5.15 Pulmonary embolus
- Section 6 The gastrointestinal system
- Section 7 Nutrition
- Section 8 The renal system
- Section 9 The neurological system
- Section 10 The metabolic and endocrine systems
- Section 11 The haematological system
- Section 12 The skin and connective tissue
- Section 13 Infection
- Section 14 Inflammation
- Section 15 Poisoning
- Section 16 Trauma
- Section 17 Physical disorders
- Section 18 Pain and sedation
- Section 19 General surgical and obstetric intensive care
- Section 20 Specialized intensive care
- Section 21 Recovery from critical illness
- Section 22 End-of-life care