Review Article

Perioperative Anesthesiological Management of Patients with Pulmonary Hypertension

Table 10

Intraoperative “basic treatment” to avoid an increase of pulmonary arterial pressure (mod. [30, 31, 39, 48, 59]).

(i) “luxury” oxygenation with inspiratory FiO2 0,6–1,0
(ii) Moderate hyperventilation (goal: PaCO2 30–35 mmHg)
(iii) Avoidance of metabolic acidosis (pH > 7,4)
(iv) Recruitment maneuver to avoid ventilation/perfusion mismatch
(v) Low-tidal-volume ventilation to avoid overinflation of aveoli (goal: 6–8 mL/kg ideal body weight)
(vii) Temperature management to maintain body temperature of 36-37°C
(viii) “goal-directed” fluid and volume therapy with hemodynamic monitoring