Right ventricular function in critically ill patients

The right ventricular function is crucial for maintaining hemodynamic stability in critically ill patients who suffer from sud-den increases of right ventricular pressure overload and/or severely decreased right ventricular contractility. The morphologi-cal and functional assessment of the right ventricle is usually performed by bedside echocardiography and hemodynamic measurements with a pulmonary artery catheter. The therapeutic approach to patients with right ventricular failure in-cludes measures to decrease right ventric-ular afterload and to improve its coronary perfusion and contractility.  

right ventricle, failure, systolic function

1. Starr I, Jeffers WA, Meade RH. The absence of conspicuous increments of venous pressure after severe damage to the right ventricle of the dog with a discussion of the relation between clinical congestive failure and heart disease. Am Heart J 1943;26:291-301.

2. Cohn JN. Right ventricular infarction revisited. Am J Cardiol 1979;43:666-8.

3. Ferlinz J. Right ventricular function in adult cardiovascular disease. Prog Cardiovasc Dis 1982;25:225-67.

4. Furey SA 3rd, Zieske HA, Levy MN. The essential function of the right ventricle. Am Heart J 1984;107:404-10.

5. Heintzen MP, Strauer BE. Acute pulmonary heart disease caused by pulmonary artery embolism. Internist 1999;40:710-21.

6. Konstantinides S. Clinical practice. Acute pulmonary embolism. N Engl J Med 2008;359:2804-13.

7. Vieillard-Baron A, Prin S, Chergui K, Dubourg O, Jardin F. Echo-Doppler demonstration of acute cor pulmonale at the bedside in the medical intensive care unit. Am J Respir Crit Care Med 2002;166:1310-9.

8. Scott RC. The S1Q3 (McGinn-White) pattern in acute cor pulmonale: a form of transient left posterior hemiblock? Am Heart J 1971;82:135-7.

9. Cheatham ML, Nelson LD, Chang MC, Safcsak K. Right ventricular end-diastolic volume index as a predictor of preload status in patients on positive end-expiratory pressure. Crit Care Med 1998;26:1801-6.

10. Lindqvist P, Henein M, and Kazzam E. Right ventricular outflow-tract fractional shortening: An applicable measure of right ven-tricular systolic function. Eur J Echocardiogr 2003;4:29-35.

11. Meluzín J, Spinarová L, Bakala J et al. Pulsed Doppler tissue imaging of the velocity of tricuspid annular systolic motion; a new, rapid, and non-invasive method of evaluating right ventricular systolic function. Eur Heart J 2001;22:340-8.

12. Lahm T, McCaslin CA, Wozniak TC et al. Medical and surgical treatment of acute right ventricular failure. J Am Coll Cardiol 2010;56:1435-46.

13. Haddad F, Doyle R, Murphy DJ, Hunt SA. Right ventricular function in cardiovascular disease, part II. Circulation 2008;117:1717–31.

14. Zamanian RT, Haddad F, Doyle RL, Weinacker AB. Management strategies for patients with pulmonary hypertension in the intensive care unit. Crit Care Med 2007;35:2037–50.

15. Kerbaul F, Rondelet B, Motte S, et al. Effects of norepinephrine and dobutamine on pressure load-induced right ventricular failure. Crit Care Med 2004;32:1035– 40.

16. Kerbaul F, Rondelet B, Demester JP, et al. Effects of levosimendan versus dobutamine on pressure load-induced right ventricular failure. Crit Care Med 2006;34:2814 –9.

17. The Acute Respiratory Distress Syndrome Network. Ventilation with lower tidal volumes as compared with traditional tidal volumes for acute lung injury and the acute respiratory distress syndrome. N Engl J Med 2000;342:1301–8.