TAMING THE SRU
YAMING THE SRU - By Josh Ferreri - May 03, 2023
SUMMARY:
The management of ARDS and right-sided heart failure can be daunting. Fortunately, we have multiple tools to combat refractory hypoxia, elevated pulmonary arterial pressures, and right ventricular failure. Of these, epoprostenol and other prostacyclin analogs have been utilized despite limited data on their actual efficacy. Though promising data has been published endorsing the use of prostacyclin analogs in the treatment of acute right sided heart failure, specifically in the setting of ARDS, there are very few randomized controlled trials providing evidence of its benefit on actual meaningful patient outcomes. Though there may be a cost benefit associated with its use, there is an urgent need for further randomized studies evaluating the use of these aerosolized pulmonary vasodilators and their impact on morbidity &mortality. Though further outcome data is certainly needed, inhaled epoprostenol is just another tool in our arsenal to help stabilize critically-ill patients several thousand feet in the sky, while transferring them to a definite center of care.