IBCC Episode 95 - Inhaled Pulmonary Vasodilators

Inhaled pulmonary vasodilators are examined for their utility in improving ventilation-perfusion matching and reducing right-to-left shunting in patients with hypoxemia. The discussion covers oxygen, nitric oxide, nitroglycerin, epoprostenol, and milrinone, addressing their mechanisms, logistical considerations, and nuances in usage. Nitroglycerin is presented as a nitric oxide delivery system, while nitric oxide is noted for its cost and potential for tachyphylaxis. Epoprostenol is compared to nitric oxide, with considerations for delivery methods and potential circuit plugging. The speakers emphasize that these vasodilators serve as a bridge to other therapies like thrombolysis or ECMO, particularly in ARDS, acute pulmonary embolism, and right ventricular myocardial infarction, used selectively for decompensating patients unresponsive to conventional treatments.