Pulmonary arterial hypertension (PAH) is a rare and progressive cardiopulmonary disease, characterized by pulmonary vasculopathy. The disease can lead to increase pulmonary arterial pressures and eventual right ventricular (RV) failure due to elevated afterload. The prevalence of PAH in patients admitted to the intensive care unit (ICU) is unknown and pulmonary hypertension (PH) in the ICU is more commonly the result of left heart disease or hypoxic lung injury (PH due to left heart disease and PH due to lung diseases and/or hypoxia, respectively), as opposed to PAH. Management of PAH patients in the ICU is complex as it requires a careful balance to maintain perfusion while optimizing right sided heart function. A comprehensive understanding of the underlying physiology and underlying hemodynamics is crucial for the management of this population. In this review, we summarized the evidence for use of vasopressors and inotropes in the management of PH and extrapolated the data to patients with PAH. We strongly believe that the understanding of the hemodynamic consequences of inotropes and vasopressors, especially from data in the PH population, can lead to better management of this complex patient population.

中文翻译：

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肺动脉高压危重患者使用正性肌力药和升压药的注意事项。

肺动脉高压（PAH）是一种罕见的进行性心肺疾病，以肺血管病变为特征。该疾病可导致肺动脉压升高，并最终因后负荷升高而导致右心室（RV）衰竭。入住重症监护病房 (ICU) 的患者中 PAH 的患病率尚不清楚，ICU 中的肺动脉高压 (PH) 更常见的是左心疾病或缺氧性肺损伤的结果（左心疾病引起的 PH 和左心疾病引起的 PH）肺部疾病和/或缺氧），而不是 PAH。ICU 中 PAH 患者的管理很复杂，因为需要仔细平衡以维持灌注，同时优化右心功能。全面了解潜在的生理学和潜在的血流动力学对于该人群的管理至关重要。在这篇综述中，我们总结了在 PH 管理中使用血管加压药和正性肌力药的证据，并将数据外推到 PAH 患者。我们坚信，了解正性肌力药和血管升压药的血流动力学后果，尤其是从 PH 人群的数据中，可以更好地管理这一复杂的患者群体。