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Pulmonary Hypertension and Right-Sided Heart Failure in the Critically Ill


 Pulmonary hypertension (PH) was defined hemodynamically at the Fifth World Symposium on Pulmonary Hypertension (WSPH) as a mean pulmonary artery (PA) pressure (mPAP) of 25 mm Hg or more. Five diagnostic groups represent the various causes of PH. Group 1 pulmonary arterial hypertension (PAH) requires both an elevated mPAP and a pulmonary vascular resistance (PVR) of at least 3 Wood units; therefore, the left-sided heart filling pressures are not elevated (pulmonary arterial wedge pressure [PAWP] ≤15 mm Hg). Conversely, in group 2 PH, left-sided heart disease causes an elevation in PAWP. Group 3 PH is due to chronic hypoxemia typically from lung disease, group 4 PH is chronic thromboembolic PH, and group 5 PH is a miscellaneous category.