Cardiovascular systemRight ventricular dysfunctionWoods, Justin; Monteiro, Patricia; Rhodes, AndrewAuthor Information Department of Anaesthesia and Intensive Care Medicine, St George's Hospital, London, UK Correspondence to Dr Andy Rhodes, Department of Anaesthesia and Intensive Care Medicine, St George's Hospital, London, SW17 0QT Tel: +44 20 8725 0884; fax: +44 20 8725 0879; e-mail: a[email protected] Current Opinion in Critical Care: October 2007 - Volume 13 - Issue 5 - p 532-540 doi: 10.1097/MCC.0b013e3282efd5a6 Buy Metrics Abstract Purpose of review Until recently the right ventricle's role in myocardial dynamics has not been fully appreciated. This article provides an overview of the pathophysiology, imaging and management of right ventricular dysfunction. Recent findings That levosimendan may promote right ventricular function opens new avenues for treatment. In addition there are existing therapies such as phosphodiesterase inhibitors and nitric oxide, which offer yet further modalities to improve outcome in right ventricular failure. How these drugs are used, in combination or alone, in conjunction with ventilatory and cardiovascular strategies has not been evaluated in multicentred randomized controlled trials. Summary Acute right ventricular dysfunction is relatively common. There is a lack of convincing evidence in favour of any single treatment modality. Imaging methods now permit a more accurate evaluation of the right ventricle and its function. Combining treatments may offer significant advantages and the imaging and monitoring available allows real-time assessment of the response to intervention. This article illustrates how incomplete our knowledge of this condition and its management within the critical care setting is and reinforces previous calls for suitably designed trials to evaluate and develop guidelines for existing strategies and therapeutic agents. © 2007 Lippincott Williams & Wilkins, Inc.