Critical Matters Right Ventricular Failure
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May 25, 2023 Join Dr. Ryan Tedford, a renowned cardiologist and expert in heart failure, as he delves into the often-overlooked role of the right ventricle in critical health scenarios. He discusses how right ventricular failure significantly impacts conditions like COVID-19 and highlights key determinants of RV function. Dr. Tedford also provides insights into effective assessment techniques, imaging tools, and emerging treatment strategies, including innovative catheter therapies. Plus, he shares recommendations for future research and resources for deeper understanding.
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Use RHC When You Need Precision
- Consider right heart catheterization when noninvasive data are unclear; invasive hemodynamics give definitive pressures and PVR.
- Use PAPI and stroke volume indices to assess RV function and prognosis.
Distinguish Acute From Chronic Carefully
- Differentiate acute vs acute-on-chronic RV failure by timing and history; look for chronic structural clues on echo.
- Use clinical course and imaging to infer chronicity when history is limited.
Don't Routinely Give Fluid
- Avoid routine fluid loading for RV failure; volume often worsens RV function and septal shift.
- Optimize preload typically by diuresis, ultrafiltration, or dialysis when appropriate.
