All issues > Volume 50(11); 2007

Review Article

Korean J Pediatr. 2007;50(11):1041-1048. Published online November 15, 2007.

Intensive management of acute right heart failure

Gi Beom GB Kim¹, Chung Il CI Noh¹

¹Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea

Correspondence Chung Il CI Noh ,Email: chungnoh@plaza.snu.ac.kr

Abstract

Not a few patients in children and adolescents are suffering from right ventricular (RV) dysfunction resulting from various conditions such as chronic lung disease, left ventricular dysfunction, pulmonary hypertension, or congenital heart defect. The RV is different from the left ventricle in terms of ventricular morphology, myocardial contractile pattern and special vulnerability to the pressure overload. Right ventricular failure (RVF) can be evaluated in terms of decreased RV contractility, RV volume overload, and/or RV pressure overload. The management for RVF starts from clear understanding of the pathophysiology of RVF. In addition to correction of the underlying disease, management of RVF per se is very important. Meticulous control of volume status, inotropic agents, vasopressors, and pulmonary selective vasodilators are the main tools in the management of RVF. The relative importance of each tool depends on the individual clinical status. Medical assist device and surgery can be considered selectively in case of refractory RVF to optimal medical treatment.

Keywords :Right ventricular failure, Blood volume, Cardiac inotropics, Vasopressor agents, Vasodilator agents