Severe Atelectasis followed by Hypoxic Pulmonary Vasoconstriction (HPV)

Mechanism of Action : Severe Atelectasis followed by Hypoxic Pulmonary Vasoconstricion (HPV).

Severe Atelectasis and Refractory Hyoxemia and Severe Systemic Hypotension

Severe Atelectasis with resultant Refractory Hypoxemia and Severe Systemic Hypotension … Mechanism of Action (MoA).

Understanding cardiac physiology – putting it all together

 

 

pvroute005

It becomes glaring obvious what needs to be done.

The RV needs to be decongested.

The LV needs to be refilled.

We can do this many ways :

> give a pulmonary vasodilator –

via inhalational route : nitric oxide, Iloprost.

via intravenous route : milrinone (we’ll discuss later).

> oxygenate the pulmonary interstitum properly (increase FiO2).

> oxygenate the pulmonary interstitium and reverse HPV via alveolar recruitment maneuver (ARM).