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Pulmonary hypertension
Chovanec, Milan ; Herget, Jan (advisor) ; Szárszoi, Ondrej (referee) ; Lindner, Jaroslav (referee)
4 Abstract Hypercapnia could be used in the treatment of critically ill patients with chronic hypoxia (cardio - pulmonary failure) as a prevention against the development of hypoxic pulmonary hypertension. This work showed the reason based on the observed difference between patients with chronic obstructive pulmonary disease and high altitude dwellers. Both groups have similar levels of oxygen saturation of haemoglobin, high altitude residents have no hypercapnia compared to patients with chronic obstructive pulmonary disease but hypercapnic sea level patients have less severe lung hypertension than mountain residents. Mortality of people with diagnosed pulmonary arterial hypertension is closely associated with right ventricle hemodynamic function (pulmonary arterial pressure, right atrial pressure and cardiac index). Recently, the therapy that has been used for pulmonary arterial hypertension has consisted of three main targets; firstly: endothelin receptor blockers, secondly: prostacycline and its analogues, thirdly: PDE-5 inhibitors in order to increase the concentration of endogenous NO and its mutual combination. Unfortunately, it is clear that the recent clinical therapy of pulmonary arterial hypertension is extremely expensive, with minimal or no effect on right ventricle hemodynamic function. In...
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