We are beginning to see more and more patients with pulmonary hypertension (PAH), many of whom are on continuous IV infusions of new medications. With that in mind, here are a few pearls:
The most common causes of rapid deterioration in patients with PAH are: catheter occlusion/pump malfunction, pneumonia, indwelling catheter infection, RV ischemia, PE, and GI bleeding
Hypotension is usually due to worsening RV failure and less likely to hypovolemia
If a catheter occlusion or pump failure is found, the drug should be restarted as soon as possible through an alternative access (including peripheral)
Calcium channel blockers, a prior treatment for PAH, are no longer indicated and should not be given
