Inhaled therapy for the management of perioperative pulmonary hypertension

C. Thunberg, S. Morozowich, Harish Ramakrishna

Research output: Contribution to journalReview articlepeer-review

12 Scopus citations

Abstract

Patients with pulmonary hypertension (PH) are at high risk for complications in the perioperative setting and often receive vasodilators to control elevated pulmonary artery pressure (PAP). Administration of vasodilators via inhalation is an effective strategy for reducing PAP while avoiding systemic side effects, chiefly hypotension. The prototypical inhaled pulmonary-specific vasodilator, nitric oxide (NO), has a proven track record but is expensive and cumbersome to implement. Alternatives to NO, including prostanoids (such as epoprostenol, iloprost, and treprostinil), NO-donating drugs (sodium nitroprusside, nitroglycerin, and nitrite), and phosphodiesterase inhibitors (milrinone, sildenafil) may be given via inhalation for the purpose of treating elevated PAP. This review will focus on the perioperative therapy of PH using inhaled vasodilators.

Original languageEnglish (US)
Pages (from-to)394-402
Number of pages9
JournalAnnals of cardiac anaesthesia
Volume18
Issue number3
DOIs
StatePublished - Jul 1 2015

Keywords

  • Nitric oxide-donating drugs
  • Phosphodiesterase inhibitors
  • Prostanoids
  • Prototypical inhaled pulmonary-specific vasodilator

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Anesthesiology and Pain Medicine

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