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Anaesthesia. 2015 Jan;70(1):56-70. doi: 10.1111/anae.12831. Epub 2014 Sep 29.

Pulmonary hypertension and its management in patients undergoing non-cardiac surgery.

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Department of Anaesthesia, The Queen Elizabeth Hospital NHS Foundation Trust, King's Lynn, UK.


Pulmonary hypertension is a complex disorder of the pulmonary vasculature that leads to increased peri-operative morbidity and mortality. Non-cardiac surgery constitutes a significant risk in patients with pulmonary hypertension. The management of right ventricular failure is inherently challenging and fraught with life-threatening consequences. A thorough understanding of the pathophysiology, the severity of the disease and its treatment modalities is required to deliver optimal peri-operative care. This review provides an evidence-based overview of the definition, classification, pathophysiology, diagnosis and treatment of pulmonary hypertension and focuses on the peri-operative management and treatment of pulmonary hypertensive crises in a non-cardiac setting.

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