Intensive care, right ventricular support and lung transplantation in patients with pulmonary hypertension.
Journal
The European respiratory journal
ISSN: 1399-3003
Titre abrégé: Eur Respir J
Pays: England
ID NLM: 8803460
Informations de publication
Date de publication:
01 2019
01 2019
Historique:
received:
05
10
2018
accepted:
09
10
2018
pubmed:
14
12
2018
medline:
2
10
2020
entrez:
15
12
2018
Statut:
epublish
Résumé
Intensive care of patients with pulmonary hypertension (PH) and right-sided heart failure includes treatment of factors causing or contributing to heart failure, careful fluid management, and strategies to reduce ventricular afterload and improve cardiac function. Extracorporeal membrane oxygenation (ECMO) should be considered in distinct situations, especially in candidates for lung transplantation (bridge to transplant) or, occasionally, in patients with a reversible cause of right-sided heart failure (bridge to recovery). ECMO should not be used in patients with end-stage disease without a realistic chance for recovery or for transplantation. For patients with refractory disease, lung transplantation remains an important treatment option. Patients should be referred to a transplant centre when they remain in an intermediate- or high-risk category despite receiving optimised pulmonary arterial hypertension therapy. Meticulous peri-operative management including the intra-operative and post-operative use of ECMO effectively prevents graft failure. In experienced centres, the 1-year survival rates after lung transplantation for PH now exceed 90%.
Identifiants
pubmed: 30545979
pii: 13993003.01906-2018
doi: 10.1183/13993003.01906-2018
pmc: PMC6351385
pii:
doi:
Substances chimiques
Antihypertensive Agents
0
Types de publication
Journal Article
Review
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
Copyright ©ERS 2019.
Déclaration de conflit d'intérêts
Conflict of interest: M.M. Hoeper reports personal fees for speaking/consulting from Actelion, Bayer, GSK and Merck. Conflict of interest: R.L. Benza has nothing to disclose. Conflict of interest: P. Corris reports grants and personal fees for lectures and consultations from Actelion and Bayer, and personal fees for lectures and consultations from MSD, during the conduct of the study. Conflict of interest: M. de Perrot reports grants and personal fees for lectures and consultations from Bayer, Merck and Actelion, during the conduct of the study. Conflict of interest: E. Fadel has nothing to disclose. Conflict of interest: A.M. Keogh reports personal fees for lectures and consultations from Bayer, Actelion, GSK and Pfizer, during the conduct of the study. Conflict of interest: C. Kühn reports personal fees for lecturing from Maquet and Zoll, during the conduct of the study. Conflict of interest: L. Savale reports grants and personal fees for lectures and consultations from Bayer and Actelion, and personal fees for lectures and consultations from GSK and MSD, during the conduct of the study. Conflict of interest: W. Klepetko has nothing to disclose.
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