Surgery and Anesthesia in Patients with Pulmonary Hypertension

Author:

Condliffe Robin12,Newton Ruth3,Bauchmuller Kris4,Bonnett Tessa5,Kerry Robert6,Mannings Alexa3,Nair Amanda3,Selby Karen5,Skinner Paul P.7,Wilson Victoria J.3,Kiely David G.12

Affiliation:

1. Pulmonary Vascular Disease Unit, Royal Hallamshire Hospital, Sheffield, United Kingdom

2. Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, United Kingdom

3. Department of Anaesthesia, Sheffield Teaching Hospitals NHS Trust, Sheffield, United Kingdom

4. Department of Critical Care, Sheffield Teaching Hospitals NHS Trust, Sheffield, United Kingdom

5. Department of Obstetrics and Gynaecology, Sheffield Teaching Hospitals NHS Trust, Sheffield, United Kingdom

6. Department of Orthopaedics, Sheffield Teaching Hospitals NHS Trust, Sheffield, United Kingdom

7. Department of Surgery, Sheffield Teaching Hospitals NHS Trust, Sheffield, United Kingdom

Abstract

AbstractPulmonary hypertension is characterized by right ventricular impairment and a reduced ability to compensate for hemodynamic insults. Consequently, surgery can be challenging but is increasingly considered in view of available specific therapies and improved longer term survival. Optimal management requires a multidisciplinary patient-centered approach involving surgeons, anesthetists, pulmonary hypertension clinicians, and intensivists. The optimal pathway involves risk:benefit assessment for the proposed operation, optimization of pulmonary hypertension and any comorbidities, the appropriate anesthetic approach for the specific procedure and patient, and careful monitoring and management in the postoperative period. Where patients are carefully selected and meticulously managed, good outcomes can be achieved.

Publisher

Georg Thieme Verlag KG

Subject

Critical Care and Intensive Care Medicine,Pulmonary and Respiratory Medicine

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