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Pulmonary vasodilators in critical illness 

Pulmonary vasodilators in critical illness
Chapter:
Pulmonary vasodilators in critical illness
Author(s):

Benjamin Chousterman

and Didier Payen

DOI:
10.1093/med/9780199600830.003.0039
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date: 18 October 2021

Pulmonary vasodilators (PV) are commonly used in the intensive care unit (ICU) to treat pulmonary hypertension and/or hypoxaemia. The choice of drug is based on its pharmacokinetic and pharmacodynamic properties. The inhaled route of administration is preferred to treat hypoxaemia as it improves the ventilation/perfusion ratio. Systemic administration of PVs can lead to a decrease of mean arterial pressure and a worsening of hypoxaemia. Despite their beneficial effects, PVs have not shown improvement in mortality in acute respiratory distress syndrome patients. Rebound of hypoxaemia and/or pulmonary arterial hypertension should be prevented during PV treatment discontinuation with a slow de-escalation protocol. This chapter reviews the use of the main PV available for use in the ICU.

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