34^th Global Summit Pulmonary Diseases & Treatment

Pulmonary Vascular Disease

Patients with pulmonary vascular disease may benefit from restoration of normal blood gases and alveolar gas composition, as alveolar hypoxia, arterial hypercarbia, and acidosis all increase pulmonary vascular tone. the pulmonary vascular disease carries some risks. Right atrial pressure, pulmonary arterial pressure, pulmonary capillary wedge pressure, systemic blood pressure, and mixed venous saturation should be routinely assessed. Cardiac output is determined by thermodilution or estimated with the modified Fick technique, but measurement rather than estimation of oxygen consumption is recommended. Pulmonary vascular resistance, in Woods units times body surface area, is calculated as mean pulmonary arterial pressure minus pulmonary capillary wedge pressure or left atrial pressure divided by cardiac output. Testing with a short-acting vasodilator allows detection of the remaining potential of reactivity of small pulmonary arteries and arterioles or demonstrates fixed resistance.