Abstract
PULMONARY HYPERTENSION (PH) is a life-threatening disease with a complex pathophysiology that if undiagnosed culminates in progressive increases in the pulmonary artery pressure (PAP) and pulmonary vascular resistance (PVR), which inevitably lead to right ventricular (RV) failure and death. 1 McLaughlin V. McGoon M. Pulmonary arterial hypertension. Circulation. 2006; 114: 1417-1431 Crossref PubMed Scopus (295) Google Scholar , 2 Farber H. Loscalzo J. Pulmonary arterial hypertension. N Engl J Med. 2004; 351 (655–166) Crossref PubMed Scopus (576) Google Scholar , 3 Fishman A.P. A century of pulmonary hemodynamics. Am J Respir Crit Care Med. 2004; 170: 109-113 Crossref PubMed Google Scholar , 4 Taichman D. Mandel J. Epidemiology of pulmonary hypertension. Clin Chest Med. 2007; 28: 1-22 Abstract Full Text Full Text PDF PubMed Scopus (35) Google Scholar , 5 Dresdale D.T. Schultz M. Michtom R.J. Primary pulmonary hypertension I, clinical and hemodynamic study. Am J Med. 1951; 11: 686-705 Abstract Full Text PDF PubMed Google Scholar Unfortunately, significant delays in diagnosis and treatment occur because of nonspecific disease symptomatology, relative low incidence (2-5 persons/million/y in the United States), and general unfamiliarity with the disease. Role of Ketamine in the Management of Pulmonary Hypertension and Right Ventricular FailureJournal of Cardiothoracic and Vascular AnesthesiaVol. 26Issue 3PreviewWe read with interest the excellent review by Strumpher and Jacobsohn of pulmonary hypertension and right ventricular dysfunction.1 However, we take issue with the authors' statement during their discussion of the management of right ventricular failure that “ketamine … increase[s] [pulmonary vascular resistance] PVR and should be avoided.” We believe it is an overly negative and simplistic assessment of the role of ketamine in this context, and that it would lead readers to dismiss an agent that has significant potential benefits in this setting. Full-Text PDF
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