PURPOSE: Pulmonary hypertension (PH) is serious condition with poor prognosis. Patients with PH ofter require intensive care. Aim of our study is to describe population of PH patients hospitalized on coronary care unit (CCU) with focus on reasons for admission and treatment used.
METHODS: We reviewed coronary care unit records between Jan 1st, 2008 and October 30th, 2009.
RESULTS: We identified 30 hospitalizations of 24 PH patients. Patients with idiopathic pulmonary arterial hypertension (n=9, 38 %) and chronic thromboembolic pulmonary hypertension (n=9, 38 %) prevailed. Vast majority (88 %, n=21) was in NYHA class III. 33 % (n=8) patients were on specific therapy for PH. The most frequent reasons for CCU admission were dyspnoea and anuria (40 %, n= 2 and 16 %, n=5 respectively). Infection was identified in 50 % of cases (n=12). Inotropic support was used in 50 % (n=15), i.v. diuretics in 80 % (n=24), noninvasive ventilation (NIV) in 37 % (n=11), mechanical ventilation in 7 % (n=2), extracorporeal membrane oxygenation in 7 % (n=2) and continuous renal replacement therapy in 10 % (n=3) of hospitalizations. Specific therapy for PH was commenced/escalated in 14 % (n=4) of patients. Average lenght of stay on CCU was 10 days. During hospitalization on CCU 17 % (n=4) of patients died.
CONCLUSION: The most frequent reasons for ICU admission are dyspnoea and renal failure (predominantly from prerenal cause- low cardiac output syndrome). Infection often contributes to worsening of clinical status. Inotropic support, diuretics, antibiotics and NIV are often necessary for successful treatment.
CLINICAL IMPLICATIONS: Physicians who care of PH patient should always be aware of possibily of worsening, predominantly due to infection and low cardiac output syndrome. They should be familiar with use of circulatory support and non-invasive ventilati0n.
DISCLOSURE: Pavel Polacek, No Financial Disclosure Information; No Product/Research Disclosure Information