Pulmonary hypertension and ICU therapies

Pulmonary hypertension and its intensive care therapies are discussed, defining pulmonary hypertension as a mean pulmonary artery pressure greater than 25 mmHg at rest. While invasive hemodynamics are the gold standard for diagnosis, echocardiography is a key screening tool, with continuous wave Doppler assessment of tricuspid valve regurgitation being a useful method for measuring mean pulmonary artery pressure. Children with pulmonary hypertension are more responsive to vasodilators but prone to severe crises. Management involves modifying factors that alter pulmonary vascular resistance, using oxygen and inhaled nitric oxide as acute pulmonary vasodilators. For long-term management, therapies target the endothelin, nitric oxide, and prostacyclin pathways, with treatment tailored to the specific type of pulmonary hypertension and the patient's condition.