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2021, Number 4

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Rev Cub Med Int Emerg 2021; 20 (4)

Acute right ventricular dysfunction in critical patients

Candel HJA, Mallo RV, Granda GYC

Language: Spanish
References: 44
Page: 1-22
PDF size: 254.84 Kb.


ABSTRACT

Introduction: Right ventricular dysfunction is a problem that occurs in multiple clinical scenarios and critical patients admitted to intensive care are the most affected, even when the cardiovascular disease per se is not the reason for its severity.
Objective: To describe acute right ventricular dysfunction and its characteristics in critically ill patients.
Method: We considered review articles, originals, case reports and consensus documents for choosing the sources to consult, most of them international. The reviewed bibliographic databases were MEDLINE, LILACS, BVS, COCHRANE LIBRARY PLUS. Full texts articles published in English and Spanish were selected. A thousand three hundred forty-nine results were obtained with the bibliographic search, but 44 were selected for the investigation. The period for preparing this review was from August to December 2020.
Results: Right ventricular dysfunction is the acute or chronic alteration of the morphology and function of the right ventricle, of multifactorial origin, it is associated with an unfavorable prognosis regardless of its etiology. Both ventricles have differences (embryology, anatomy), what makes the pathophysiological response to injury different. The adaptation of the right ventricle is determined by the degree of hemodynamic overload and the time of exposure to these processes (pressure overload, volume overload and contractile failure), hence the importance of optimizing each of these determinants in medical management.
Conclusion: Right ventricular dysfunction is the morphofunctional alteration of said structure, of multietiological origin and with poor prognosis in most cases. It can present overlapping in the critical patient. For its correct stratification and handling, Eco bedside is an indispensable tool.


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