Preoperative Assessment and Perioperative Management of the Patient with Pulmonary Vascular Disease

Jochen Steppan; Paul M Heerdt

doi:10.1016/j.ccm.2020.11.013

Preoperative Assessment and Perioperative Management of the Patient with Pulmonary Vascular Disease

Clin Chest Med. 2021 Mar;42(1):133-141. doi: 10.1016/j.ccm.2020.11.013. Epub 2021 Jan 8.

Authors

Jochen Steppan¹, Paul M Heerdt²

Affiliations

¹ Johns Hopkins University, School of Medicine, Department of Anesthesiology and Critical Care Medicine, Baltimore, MD, USA. Electronic address: J.Steppan@jhmi.edu.
² Department of Anesthesiology Yale School of Medicine, Division of Applied Hemodynamics, New Haven, CT, USA.

Abstract

The incidence of pulmonary hypertension (PH) in patients undergoing noncardiac surgery has increased steadily over the past decade. Patients with known PH have significantly higher perioperative morbidity and mortality than those without PH. Moreover, a substantial number of patients may have occult disease. It, therefore, is of paramount importance for perioperative providers to recognize high-risk patients and treat them appropriately. This review first provides an overview of PH pathophysiology, then estimates the perioperative incidence of PH and its impact on surgical outcomes, and finally outlines a perioperative management strategy.

Keywords: Anesthesia; Pulmonary hypertension; Surgery.

Publication types

Research Support, N.I.H., Extramural
Review

MeSH terms

Humans
Hypertension, Pulmonary* / epidemiology
Hypertension, Pulmonary* / physiopathology
Incidence
Perioperative Care / methods*
Perioperative Period / methods*
Vascular Diseases / epidemiology
Vascular Diseases / physiopathology

Abstract

Publication types

MeSH terms

Grants and funding