![]() Lankhaar JW, Westerhof N, Faes TJC, et al. The critical role of pulmonary arterial compliance in pulmonary hypertension. Thenappan T, Prins KW, Pritzker MR, Scandurra J, Volmers K, Weir EK. ePLAR - the echocardiographic pulmonary to left atrial ratio - a novel non-invasive parameter to differentiate pre-capillary and post-capillary pulmonary hypertension. Pulmonary artery diastolic and wedge pressure relationships in critically ill and injured patients. Wilson RF, Beckman SB, Tyburski JG, Scholten DJ. Optimizing diastolic pressure gradient assessment. Diastolic pulmonary vascular pressure gradient: a predictor of prognosis in “out-of-proportion” pulmonary hypertension. 2015 ESC/ERS guidelines for the diagnosis and treatment of pulmonary hypertension. Guidelines for the diagnosis and treatment of pulmonary hypertension. Nature of pulmonary hypertension in canine oleic acid pulmonary edema. Leeman M, Lejeune P, Closset J, Vachiery JL, Melot C, Naeije R. The transpulmonary pressure gradient for the diagnosis of pulmonary vascular disease. Naeije R, Vachiery JL, Yerly P, Vanderpool R. Applied physiology in intensive care medicine. A meaningless variable? In: Pinsky MR, Brochard L, Hedenstierna G, Antonelli M, editors. Alveolar pressure, pulmonary venous pressure, and the vascular waterfall. Distribution of blood flow in isolated lung relation to vascular and alveolar pressures. A simple distensible model for interpreting pulmonary vascular pressure-flow curves. Pathophysiology of the right ventricle and of the pulmonary circulation in pulmonary hypertension: an update. Vonk Noordegraaf A, Chin KM, Haddad F, et al. Distensibility of the normal human lung circulation during exercise. Hematocrit-corrected pulmonary vascular resistance. The acutely decompensated right ventricle: pathways for diagnosis and management. Endothelial cell dysfunction: a major player in SARS-CoV-2 infection (COVID-19)? Eur Respir J. Effects of blood flow on lung ACE kinetics: evidence for microvascular recruitment. Pulmonary artery adventitial changes and venous involvement in primary pulmonary hypertension. 2017 69:236–43.Ĭhazova I, Loyd JE, Zhdanov VS, Newman JH, Belenkov Y, Meyrickt B. The relationship between the right ventricle and its load in pulmonary hypertension. Vonk Noordegraaf A, Westerhof BE, Westerhof N. Pulmonary vascular and right ventricular dysfunction in adult critical care: current and emerging options for management: a systematic literature review. Price LC, Wort SJ, Finney SJ, Marino PS, Brett SJ. Role of acid sphingomyelinase and IL-6 as mediators of endotoxin-induced pulmonary vascular dysfunction. Pathophysiology of pulmonary hypertension in acute lung injury. Price LC, McAuley DF, Marino PS, Finney SJ, Griffiths MJ, Wort SJ. Measurement by the pulmonary arterial diastolic-pulmonary wedge pressure gradient and the influence of passive and active factors. Sibbald W, Paterson NAM, Holliday RL, Anderson RA, Lobb TR, Duff JH. Pulmonary hypertension in severe acute respiratory failure. Pulmonary vascular dysfunction is associated with poor outcomes in patients with acute lung injury. Philadelphia: Lippincott Williams and WIlkins 2010. Arteriovenous shunts in the peripheral pulmonary circulation in the human lung. Right ventricular- pulmonary arterial coupling.An important pathway for the intensive care physician manipulating hemodynamics at the bedside is the route linking the right and left atrium, and perhaps this route through the ‘forgotten circulation’ is where we should focus our attention. This chapter will overview the factors governing the transpulmonary pressure gradient including pulmonary vascular resistance and pulmonary arterial compliance and its relevance to management of pulmonary hypertension and right ventricular dysfunction in critical illness. With advanced critical care echocardiography and possible resurgence in the use of contemporary pulmonary artery catheters, intensivists can lead the way in bedside research targeting the ‘right ventricular-pulmonary circuit’ in critical illness. This is the essential pressure that overcomes vascular resistance and is a cornerstone of hemodynamic resuscitation, enabling oxygenation and cardiac output. The driving force of pulmonary blood flow is the pressure difference between the pulmonary artery and left atrium (known as the transpulmonary pressure gradient).
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