Table 2 General clinical management parameters for perioperative RV management
From: Perioperative management of the vulnerable and failing right ventricle
Parameter and goal | Rationale |
|---|---|
PaCO2 = 30– 35 mmHg | Avoid hypercarbia-induced pulmonary vasoconstriction |
pH ≥ 7.4 | Avoid acidosis-induced pulmonary vasoconstriction |
Plateau pressures < 27–30 cmH2O with low tidal volumes (6–8 mL/kg predicted body weight) (McGlothlin et al. 2022; Arrigo et al. 2019; Strumpher and Jacobsohn 2011) | Minimize intrathoracic pressure-induced PVR elevation |
SaO2 > 92% | Adequate oxygenation to prevent hypoxia-induced pulmonary vasoconstriction |
Optimize PEEP | Improve alveolar recruitment but avoid hyperinflation (aim 5–10 cmH2O) |