Right ventricular dysfunction in the intensive care unit

Abstract

Assessing right ventricular (RV) function in acute conditions, such as circulatory and respiratory failure, is of great importance for hemodynamic monitoring and therapeutic adaptation (1, 2). Right ventricular function is responsible for the back-pressure of systemic venous return (3), and for the amount of blood that reaches the pulmonary circulation, which is one of the main determinants of left ventricular (LV) stroke volume (4). Right ventricular failure in septic shock may explain why blood volume expansion is unable to increase cardiac output (5). In certain conditions, such as massive pulmonary embolism (PE) and acute respiratory distress syndrome (ARDS), RV failure may be the main cause of shock, leading to specific therapeutic interventions such as thrombolysis or limitation of airway pressures. Before considering the main causes of RV dysfunction, it is essential to understand the specific features of RV physiology. © 2008 Springer-Verlag London.