Pulmonary hypertension
Patient (condition)
 
Aliases:
PHT
PAH
Pulmonary Artery Hypertension
PA Hypertension

Topic aliases are alternate phrasings for a particular topic.


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Primary (idiopathic) pulmonary hypertension (PPH) is rare. Cause is unknown (hence idiopathic) & life expectancy is 2-3 yrs from diagnosis.
Secondary PH is more common, & usually due to underlying pulmonary or cardiovascular disease.

Primary concerns are assessing disease severity, preoperative optimisation, clarifying perioperative risk, heightened monitoring, & minimising intraoperative elevation of pulmonary artery pressures refl.in/eh

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Nov 21, 2012
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Pulmonary artery hypertension (PAH) is defined as a mean pulmonary arterial (PAP) pressure of greater than 25 mm Hg at rest, or greater than 30 mm Hg during exercise. refl.in/eg refl.in/eh

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Aug 20, 2011
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WHO classification:
1. Pulmonary artery hypertension (PAH);
2. PAH due to left heart disease;
3. PAH due to pulmonary disease;
4. chronic thromboembolic-pulmonary-hypertension;
5. PAH with unclear multifactorial mechanisms. refl.in/ei

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Apr 15, 2012
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Trans-thoracic echocardiogram TTE may indicate an estimated pulmonary artery pressure, although note that pulmonary artery pressures may tend to normalise in decompensated right ventricular failure.

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Aug 20, 2011
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Check medications for anticoagulants. Patient may be anticoagulated ( warfarin, clexane) as this may have a mortality benefit in patients with pulmonary hypertension. refl.in/ef

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Nov 21, 2012
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Any two of the following features allocates the patient to the high risk group

#adamskinner #RCHmelbourne

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Oct 05, 2016
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If pulmonary hypertension is present during pregnancy, consider preadmisison to intensive care unit prior to delivery. #improve

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Aug 20, 2011
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Perianaesthesia protocol for high risk patients at #RCHMelbourne (Rosella is ICU)

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Oct 05, 2016
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Perianaesthesia protocol for mid risk patients at #RCHMelbourne

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Oct 05, 2016
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Perioperative guidelines for patients with pulmonary arterial hypertension at Royal Childrens Hospital Melbourne

www.rch.org.au/rchcpg/hos...

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Oct 05, 2016
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Refer the patient to their physician if there has been no review within the last 6 months, or if symptoms have worsened since last appointment.

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Apr 15, 2012
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A pulmonary artery-catheter may be indicated in patients with severe PAH undergoing major surgery to monitor and manage elevations in pulmonary artery pressure perioperatively.

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Mar 26, 2013
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Pre-induction arterial line is indicated in patients with moderate-severe pulmonary hypertension undergoing major surgery to monitor for haemodynamic dysfunction at induction.

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Apr 15, 2012
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Avoid hypercarbia and hypoxia which may raise pulmonary vascular-resistance

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Nov 21, 2012
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Avoid acidemia which may raise pulmonary vascular resistance

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Aug 20, 2011
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Avoid hypothermia which may raise pulmonary vascular resistance

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Aug 20, 2011
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Before inducing patients with severe pulmonary hypertension have an adrenaline infusion prepared ready to give in case of haemodynamic instability.

In patients that arrest at intubation is highly, likely consider having adrenaline infusion already running and primed in the central line if one is present.

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Apr 10, 2013
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Overview of management of pulmonary hypertension in children

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Jun 23, 2018
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Treatment of the pulmonary hypertensive crisis from Texas Children's Hospital
#spanza2012

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Mar 26, 2013
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