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Right ventricular failure in ICU



Intended Learning Outcomes

Right ventricular failure in ICU

  1. Describe the epidemiology and importance of right ventricular failure in intensive care medicine
  2. Understand the normal anatomy and physiology of the right ventricle
  3. Understand the concepts of preload, afterload, coupling and ventricular interdependence in relation to the right ventricle.
  4. Describe the pathophysiology of the failing right ventricle
  5. Describe the variety of clinical conditions related to right ventricular failure in intensive care.
  6. Demonstrate the work up of a patient with right ventricular failure including clinical assessment and key investigations
  7. Describe a structured approach to management including attention to rate/rhythm, coronary perfusion, preload, contractility and afterload.
  8. Describe the indications and timings for short term mechanical circulatory support in acute right ventricular failure
  9. Describe the key features of mechanical circulatory support including TandemHeart, ImpellaRP and veno-arterial extracorporeal membrane oxygenation.
  10. Understand the role of long term mechanical support and heart transplantation

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Relevant competencies from CoBaTrICE

Right ventricular failure in ICU

  • 1.1 Adopts a structured and timely approach to the recognition, assessment and stabilization of the acutely ill patient with disordered physiology
  • 1.3 Manages the patient post-resuscitation
  • 2.2 Undertakes timely and appropriate investigations
  • 2.3 Describes indications for echocardiography (transthoracic / transesophageal)
  • 2.4 Performs electrocardiography (ECG / EKG) and interprets the results
  • 2.9 Monitors and responds to trends in physiological variables
  • 2.10 Integrates clinical findings with laboratory investigations to form a differential diagnosis
  • 3.1 Manages the care of the critically ill patient with specific acute medical conditions
  • 3.2 Identifies the implications of chronic and co-morbid disease in the acutely ill patient
  • 3.3 Recognises and manages the patient with circulatory failure
  • 4.4 Uses fluids and vasoactive / inotropic drugs to support the circulation
  • 4.5 Describes the use of devices for circulatory or respiratory assist
  • 5.17 Demonstrates a method for measuring cardiac output and derived haemodynamic variables