Right Ventricular Failure & Pulmonary Hypertension

The podcast addresses right ventricular (RV) failure, emphasizing its underestimated prevalence and the importance of understanding RV physiology for effective resuscitation. It highlights that RV dysfunction significantly increases mortality in conditions like sepsis, ARDS, heart failure and COVID-19. The discussion outlines three key principles of RV physiology: its sensitivity to mistakes, vulnerability to resistance, and dependence on constant perfusion. The podcast introduces a framework for diagnosing RV failure based on pressure overload, volume overload, and decreased contractility. It warns against excessive fluid administration, advocating instead for cautious diuresis and the use of pulmonary vasodilators to manage RV afterload. The podcast also stresses the importance of maintaining systemic blood pressure to ensure adequate RV perfusion and advises caution when considering intubation due to associated risks.