If you don't remember your password, you can reset it by entering your email address and clicking the Reset Password button. You will then receive an email that contains a secure link for resetting your password
If the address matches a valid account an email will be sent to __email__ with instructions for resetting your password
Corresponding author: Dr Varinder K. Randhawa, Department of Critical Care Medicine, Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, Toronto, Ontario, M4N 3M5, Canada.
Department of Critical Care Medicine, Sunnybrook Health Sciences Centre, Toronto, Ontario, CanadaDepartment of Medicine, University of Toronto, Toronto, Ontario, Canada
Department of Critical Care Medicine, Sunnybrook Health Sciences Centre, Toronto, Ontario, CanadaDepartment of Medicine, University of Toronto, Toronto, Ontario, Canada
Department of Critical Care Medicine, Sunnybrook Health Sciences Centre, Toronto, Ontario, CanadaDepartment of Medicine, University of Toronto, Toronto, Ontario, Canada
Department of Cardiac Surgery, Sunnybrook Health Sciences Centre, Toronto, Ontario, CanadaDepartment of Medicine, University of Toronto, Toronto, Ontario, Canada
Right ventricular (RV) dysfunction and pulmonary hypertension (PH) in patients undergoing
cardiac surgery contribute to significant perioperative morbidity and mortality.
the safety and efficacy of inhaled pulmonary vasodilators on perioperative RV function
and hemodynamics remains poorly understood. In the study by Elmi-Sarabi, Denault,
and colleagues, published in this issue of the Canadian Journal of Cardiology,
the impact of inhaled dual pulmonary vasodilators in patients with or without RV
dysfunction and PH undergoing cardiac surgery highlight several important areas for
exploration (Figure 1): the safety and effectiveness of nebulized dual pulmonary vasodilators, inhaled
epoprostenol (iE) and inhaled milrinone (iM); their impact on RV systolic and diastolic
function and afterload and ventriculoarterial coupling; the optimal mode, timing,
dose, and duration of drug administration; and the ability to predict therapeutic
responsiveness and influence clinical outcomes.
Figure 1Right ventricular hemodynamics and inhaled pulmonary vasodilators. Shown is a summary
of patient selection criteria, therapy delivery, and therapeutic responsiveness of
right ventricular hemodynamics to dual inhaled pulmonary vasodilators. EuroSCORE II,
European System for Cardiac Operative Risk Evaluation score II; MAP, mean arterial
pressure; PAP, pulmonary artery pressure; PH, pulmonary hypertension; RV, right ventricular.
Dobutamine-induced changes in pulmonary artery pressure in patients with congestive heart failure and their relation to abnormalities of lung diffusing capacity.
Pulmonary hypertension (PH) and right ventricular (RV) dysfunction are major complications in cardiac surgery. This study aimed to evaluate the change in RV pressure waveform in patients receiving a combination of inhaled epoprostenol and inhaled milrinone (iE&iM) before cardiopulmonary bypass (CPB) and to assess the safety of this approach with a matched case-control group.
