Immediate Management

Pulmonary Hypertension Management Immediate Management

Management of the acutely ill patient with PH should include careful evaluation for secondary causes of decompensation (such as a low-grade line infection or pulmonary thromboembolism).

The management approach can be broadly divided into two stages: immediate ED management and subsequent or specialist management. Immediate ED management options are presented below.

Problem	Intervension(s) required
Hypoxaemia	Supplemental oxygen
Arrhythmias	Beta blockers Calcium channel blockers Digoxin
Volume overload	Diuretics Inotropes or vasopressors
Acute right heart failure	Spironolactone Digoxin Search for underlying precipitant
Cardiac arrest	Advanced life support resuscitation while searching for underlying precipitant
Technical intravenous catheter and pump problems	Prompt restoration of intravenous therapy
Catheter-related infection	Prompt blood cultures Empiric initiation of appropriate antibiotic therapy
Bleeding in warfarinised PH patients	Avoidance of unnecessary punctures (e.g. arterial blood gas sampling) Correct INR Search and correct underlying cause (e.g. drug interaction)

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