『Diagnosis & Management of Pulmonary Hypertension in the CICU with Dr. Manreet Kanwar』のカバーアート

Diagnosis & Management of Pulmonary Hypertension in the CICU with Dr. Manreet Kanwar

Diagnosis & Management of Pulmonary Hypertension in the CICU with Dr. Manreet Kanwar

無料で聴く

ポッドキャストの詳細を見る

【Amazonプライム会員限定】今ならプレミアムプランが4か月 月額99円。

10月19日まで。※適用条件あり
Is that "pulmonary hypertension" on the echo report actually driving your patient's shock, or is it just along for the ride? In this episode of SoCCC Pre-Rounds, Dr. Anthony Carnicelli is joined by Dr. Manreet Kanwar, an internationally recognized expert in pulmonary hypertension, cardiogenic shock, mechanical circulatory support, advanced heart failure, and heart transplantation, for a practical discussion on managing pulmonary hypertension in the cardiac intensive care unit. Together, they explore how clinicians can move beyond simply recognizing elevated pulmonary pressures to identifying the underlying disease process driving a patient's deterioration.Dr. Kanwar explains why pulmonary hypertension should be viewed as a hemodynamic finding rather than a standalone diagnosis and why understanding its effect on the right ventricle is central to caring for critically ill patients. The conversation covers early bedside assessment, optimizing preload, the challenges of respiratory support, vasopressor selection, and the careful use of temporary mechanical circulatory support. Throughout the discussion, he emphasizes protecting the right ventricle while treating the underlying cause of pulmonary hypertension.Whether you're admitting a patient with decompensated pulmonary hypertension or managing acute right ventricular failure overnight, this episode provides a thoughtful framework for approaching one of the CICU's most challenging patient populations.Key TakeawaysPulmonary hypertension is a hemodynamic finding that requires identifying and treating the underlying cause.Right ventricular function should guide bedside assessment and management decisions in critically ill patients.Optimal preload is patient-specific and should be individualized rather than managed with blanket rules.Mechanical ventilation can worsen right ventricular failure and should be approached with caution.Norepinephrine and vasopressin are preferred vasopressors for hypotensive patients with pulmonary hypertension, while phenylephrine is generally avoided.Temporary mechanical circulatory support requires a clear exit strategy before implantation.In This Episode[00:00] Introduction[01:37] Defining pulmonary hypertension [04:20] Evaluating the critically ill patient with pulmonary hypertension[06:41] Right ventricular failure and preload management[09:46] Respiratory support and the risks of mechanical ventilation[13:26] Vasopressors and temporary mechanical circulatory support[17:44] Final clinical pearls for intensivists[19:11] Closing remarks Notable Quotes[02:49] "Pulmonary hypertension in itself is not a single disease. It is a hemodynamic finding. The key is to figure out the why." — Dr. Manreet Kanwar[11:13] "If you let the patient be very hypoxic or hypercarbic or wait till they're very acidotic to do something about it, this RV will just give out." — Dr. Manreet Kanwar[14:31] "When in doubt, use Levophed. Norepinephrine is always the drug of choice in all circumstances, period." —Dr. Manreet Kanwar[16:00] "Putting devices in is easy. It's the art of taking them out that becomes very, very tricky." —Dr. Manreet Kanwar[19:01] "Go forth and protect the RVs." — Dr. Manreet KanwarResources and LinksBecome a member of the Community: https://www.soccc.org/subscribeDr. Manreet Kanwarhttps://biologicalsciences.uchicago.edu/faculty/manreet-kanwar-mdhttps://www.linkedin.com/in/manreet-kanwar-aa9897aaDr. Anthony Carnicellihttps://www.soccc.org/https://www.linkedin.com/in/anthony-carnicelli-926a0b88/Supported By:This episode is made possible by unrestricted support from Zoll LifeVest — thanks for keeping high-impact education free for our community.DisclaimerThis podcast is not medical advice, just candid, practical discussions about what your hosts do every day in the CICU. Always consult your supervising team and current guidelines before applying any interventions.
adbl_web_anon_alc_button_suppression_t1
まだレビューはありません