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Table 1 Causes of pulmonary hypertension and right ventricle failure in the ICU

From: Pulmonary vascular and right ventricular dysfunction in adult critical care: current and emerging options for management: a systematic literature review

Causes of pulmonary hypertension in ICU

Causes of RV failure in ICU

1) PAH (for example, preexisting PAH; PoPH (8.5% ESLD)

1) RV Pressure overload, pulmonary hypertension, any cause

2) Elevated LAP: RV pressure overload (left-sided myocardial infarction/cardiomyopathy; mitral regurgitation; pulmonary stenosis)

2) Reduced RV contractility

3) PH due to hypoxia: acute (for example, ARDS)/preexisting lung disease (for example, COPD, IPF)

   RV infarction; sepsis; RV cardiomyopathy; myocarditis; pericardial disease; LVAD; after CPB; after cardiac surgery/transplantation

4) Thromboembolic (for example, acute PE; chronic (CTEPH); other causes of emboli (AFE, air, cement)

3) RV-volume overload

5) Mechanical (for example, increased Pplat - IPPV

   Cardiac causes: tricuspid and pulmonary regurgitation; intracardiac shunts

  1. AFE, amniotic fluid embolus; ARDS, acute respiratory distress syndrome; COPD, chronic obstructive pulmonary disease; CPB, cardiopulmonary bypass; CTEPH, chronic thromboembolic pulmonary hypertension; ESLD, end-stage liver disease; IPF, idiopathic pulmonary fibrosis; IPPV, intermittent positive-pressure ventilation; LAP, left atrial pressure; LVAD, left ventricular assist device; PAH, pulmonary arterial hypertension; PoPH, portopulmonary hypertension; Pplat, plateau pressure; RV, right ventricle.
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Critical Care

ISSN: 1364-8535