{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T07:02:58Z","timestamp":1791442978717,"version":"4.3.3"},"reference-count":112,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,3,2]],"date-time":"2023-03-02T00:00:00Z","timestamp":1677715200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cardiovasc. Med."],"abstract":"<jats:p>The management of sepsis in patients with pulmonary hypertension (PH) is challenging due to significant conflicting goals of management and complex hemodynamics. As PH progresses, the ability of right heart to perfuse lungs at a normal central venous pressure (CVP) is impaired. Elevated pulmonary vascular pressure, due to pulmonary vasoconstriction and vascular remodeling, opposes blood flow through lungs thus limiting the ability of right ventricle (RV) to increase cardiac output (CO) and maintain adequate oxygen delivery to tissue. In sepsis without PH, avoidance of volume depletion with intravascular volume replacement, followed by vasopressor therapy if hypoperfusion persists, remains the cornerstone of therapy. Intravenous fluid (IVF) resuscitation based on individualized hemodynamic assessment can help improve the prognosis of critically ill patients. This is accomplished by optimizing CO by maintaining adequate preload, afterload and contractility. Particular challenges in patients with PH include RV failure as a result of pressure and volume overload, gas exchange abnormalities, and managing IVF and diuretic use. Suggested approaches to remedy these difficulties include early recognition of symptoms associated with pressure and volume overload, intravascular volume management strategies and serial lab monitoring to assess electrolytes and renal function.<\/jats:p>","DOI":"10.3389\/fcvm.2023.1096871","type":"journal-article","created":{"date-parts":[[2023,3,2]],"date-time":"2023-03-02T05:30:25Z","timestamp":1677735025000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":13,"title":["Fluid management in septic patients with pulmonary hypertension, review of the literature"],"prefix":"10.3389","volume":"10","author":[{"given":"Blerina","family":"Asllanaj","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth","family":"Benge","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jieun","family":"Bae","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi","family":"McWhorter","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2023,3,2]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"e578","DOI":"10.1161\/CIR.0000000000000560","article-title":"Evaluation and management of right-sided heart failure: a scientific statement from the American heart association","volume":"137","author":"Konstam","year":"2018","journal-title":"Circulation."},{"key":"B2","doi-asserted-by":"publisher","first-page":"1368","DOI":"10.1056\/NEJMoa010307","article-title":"Early goal-directed therapy in the treatment of severe sepsis and septic shock","volume":"345","author":"Rivers","year":"2001","journal-title":"N Engl J Med."},{"key":"B3","doi-asserted-by":"publisher","first-page":"486","DOI":"10.1097\/CCM.0000000000002255","article-title":"Surviving sepsis campaign: international guidelines for management of sepsis and septic shock","volume":"45","author":"Rhodes","year":"2017","journal-title":"Crit Care Med"},{"key":"B4","doi-asserted-by":"publisher","first-page":"997","DOI":"10.1097\/CCM.0000000000003119","article-title":"The surviving sepsis campaign bundle","volume":"46","author":"Levy","year":"2018","journal-title":"Crit Care Med"},{"key":"B5","doi-asserted-by":"publisher","first-page":"4391","DOI":"10.1101\/166470","article-title":"Frank-Starling mechanism and short-term adjustment of cardiac flow","volume":"23","author":"Chaui-Berlinck","year":"2017","journal-title":"J Exp Biol"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1152\/physrev.1955.35.1.123","article-title":"Determination of cardiac output by equating venous return curves with cardiac response curves","author":"Guyton","year":"1955","journal-title":"Physiol Rev"},{"key":"B7","doi-asserted-by":"publisher","first-page":"H1725","DOI":"10.1152\/ajpheart.1992.262.6.H1725","article-title":"Restraining effect of intact pericardium during acute volume loading","volume":"262","author":"Applegate","year":"1992","journal-title":"Am J Physiol"},{"key":"B8","doi-asserted-by":"publisher","first-page":"43","DOI":"10.1186\/s13054-018-1959-3","article-title":"Should we measure the central venous pressure to guide fluid management? 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