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Pharmacology of the Pulmonary Circulation

  • Cara ReimerEmail author
  • John Granton
Chapter

Abstract

The pulmonary vasculature is a complex system, and studies of the effects of anesthetic drugs on this system are often contradictory. A balanced anesthetic technique with adherence to the hemodynamic goals of maintenance of right ventricular preload and right coronary artery perfusion is the safest choice for patients with PHTN. There are no absolute contraindications to most anesthetic drugs in patients with pulmonary hypertension. Inhaled pulmonary vasodilators can be used to optimize hemodynamic variables perioperatively, although effects on gas exchange are variable.

Keywords

Pulmonary hypertension Right ventricle Pharmacology Pulmonary vascular disease Anesthesia 

Abbreviations

(m)PAP

(mean) Pulmonary artery pressure

CI

Confidence interval

CO

Cardiac output

LAP

Left atrial pressure

PHTN

Pulmonary hypertension

PVB

Paravertebral block

PVR(I)

Pulmonary vascular resistance (index)

SVR(I)

Systemic vascular resistance (index)

TEA

Thoracic epidural analgesia

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© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Department of Anesthesiology and Perioperative MedicineKingston Health Sciences CentreKingstonCanada
  2. 2.Division of Respirology, Department of MedicineUniversity of Toronto and University Health Network, Mount Sinai Hospital, Women’s College HospitalTorontoCanada

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