ESC ACVC RV Failure 2023 — Diagnosis and treatment of right ventricular failure secondary to acutely increased right ventricular afterload (acute cor pulmonale): a clinical consensus statement
ESC Association for Acute CardioVascular Care, 2023
Provides a practical ICU framework for acute cor pulmonale and RV failure, emphasizing diagnosis of the precipitating cause, cautious preload optimization, maintenance of systemic perfusion, reduction of reversible pulmonary vascular load, ventilator optimization, selective vasoactive/inotropic therapy, and specialist mechanical support for refractory cases.
Clinical Context & Relevant Topics (4)
Disease ReferenceRV anatomy and ischemia spiral, ventricular interdependence (D-sign), echocardiographic metrics (TAPSE, S', PAPi, VExUS), and the 4-pillar resuscitation strategy.
Hemodynamic classification, right ventricular afterload reduction, selective pulmonary vasodilation, and pulmonary hypertensive crisis management.
Extracardiac mechanical barriers to filling or ejection: Massive PE, Cardiac Tamponade, Tension Pneumothorax, and Auto-PEEP.
Acute, diffuse inflammatory lung injury causing hypoxemia and bilateral infiltrates not fully explained by cardiac failure or fluid overload.