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).