Perioperative anesthetic considerations in patients with pulmonary hypertension undergoing non-cardiac and non-obstetric surgeries

Abstract

The management of pulmonary hypertension (PH), one of the most important perioperative risk factors, is innately challenging to anesthesiologists owing to its life-threatening consequences. The number of patients with PH has increased because of the development of more effective treatment and advanced hemodynamic monitoring, which consequently result in a longer life-expectancy. By understanding the associated risk factors, utilizing therapies based on PH classification, and performing careful perioperative anesthetic planning and management, we can safely perform elective surgeries or procedures on these patients. In particular, the perioperative management of patients with PH requires a multidisciplinary approach, which is aimed at carefully optimizing hemodynamics, minimizing risk factors, and aggressively treating complications. This review provides an evidence-based overview of the definition and classification of and treatments for PH, while also focusing on the perioperative management and treatment of patients with PH in non-cardiac and non-obstetric settings.