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Welcome to the Atomic Anesthesia podcast hosted by CRNA professor Dr. Rhea Temmermand and Co-Founder Sachi Lord. On this show, you'll hear clear, clinically grounded discussions designed for nurse anesthesia residents and CRNAs who want to feel more confident in complex pharmacology, physiology, and real-world anesthesia decision-making.
Pulmonary hypertension can feel like a pile of numbers, groups and drug names, but board questions keep coming back to one idea: protect the right ventricle. In week 5 of our 12-week SEE/NCE series, we start with a patient on daily sildenafil whose blood pressure falls after propofol, and we show you how to recognize the RV failure spiral and what to do first.
In this episode:
- The current definition of pulmonary hypertension and how wedge pressure and PVR separate precapillary from postcapillary diseaseThe five WHO groups, plus a memory trick to place any patientThe RV failure spiral and why systemic hypotension is so dangerousWhat raises PVR (hypoxemia, hypercarbia, acidosis, hypothermia, pain) and what lowers it, including why nitrous oxide is the gas to avoidManaging acute right ventricular failure on induction with vasopressors, inotropes and inhaled nitric oxideWhy nitroglycerin is dangerous in a patient taking sildenafil
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