Pulmonary Vasodilators and Anesthesia Considerations

Anesthesiol Clin. 2017 Jun;35(2):221-232. doi: 10.1016/j.anclin.2017.01.008. Epub 2017 Apr 14.

Abstract

Pulmonary hypertension (PH) is a complex disease process of the pulmonary vasculature system characterized by elevated pulmonary arterial pressures. Patients with PH are at increased risk for morbidity and mortality, including intraoperatively and postoperatively. Appreciation by the clinical anesthesiologist of the pathophysiology of PH is warranted. Careful and meticulous strategy using appropriate anesthetic medications, pulmonary vasodilator and inotropic agents, and careful fluid management all increase the likelihood of the best possible outcome in this challenging patient population.

Keywords: Anesthesia; Calcium channel blockers; Endothelin antagonists; Inhaled nitric oxide; Prostacyclin; Pulmonary hypertension.

Publication types

  • Review

MeSH terms

  • Anesthesia*
  • Humans
  • Hypertension, Pulmonary / drug therapy*
  • Hypertension, Pulmonary / etiology
  • Muscle, Smooth, Vascular / drug effects
  • Muscle, Smooth, Vascular / physiology
  • Nitric Oxide / administration & dosage
  • Pulmonary Circulation / drug effects
  • Pulmonary Circulation / physiology
  • Vascular Resistance / drug effects
  • Vascular Resistance / physiology
  • Vasodilator Agents / therapeutic use*

Substances

  • Vasodilator Agents
  • Nitric Oxide