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Management of PH in the ICU

Todd Bull


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Course ID: 2935

Course Title 

Management of Pulmonary Hypertension (PH) in the ICU 

Course Author

Todd M. Bull, M.D.
Professor of Medicine
Division of Pulmonary Sciences and Critical Care Medicine
Department of Medicine
University of Colorado | Anschutz Medical Campus
Aurora, Colo.

Learning Objectives

At the conclusion of this activity participants should be able to:

  1. Review the normal function of the pulmonary vascular bed
  2. Describe the impact of sudden increases in right ventricular afterload on cardiac output
  3. Describe the impact of hypercarbia, hypoxia, and mechanical ventilation on pulmonary vascular resistance
  4. Discuss two common cardiac arrhythmias that can contribute to critical illness in patients with PAH and their management
  5. Discuss strategies to enhance right ventricular-pulmonary artery interaction in critical illness 

Planning Committee

Michael A. Mathier, M.D.
Associate Professor of Medicine
Director, Pulmonary Hypertension Program
Division of Cardiology
Department of Medicine
University of Pittsburgh
Pittsburgh, Pa.

Michael Patrick Gray, M.P.H.
Senior Director, Medical Services
Pulmonary Hypertension Association, Inc.
Silver Spring, Md.

Content Reviewer

Murali Chakinala, M.D.
Associate Professor of Medicine
Division of Pulmonary and Critical Care Medicine
Washington University School of Medicine in St. Louis
St. Louis, Mo.

CME Reviewer

Allyson R. Zazulia, M.D.
Associate Dean, Continuing Medical Education
Washington University School of Medicine in St. Louis
St. Louis, Mo.

Intended Audience

This activity has been designed for pulmonologists, cardiologists, rheumatologists, internists, and primary care physicians, as well as nurses, physician assistants, and other allied health professionals who help care for patients with pulmonary hypertension (PH). This activity is designed to improve knowledge, competence, performance, and patient care practices by instructing front-line clinicians in the highest quality of care for patients with PH.

Release Date

18 August 2017

Expiration Date

17 August 2019

Estimated Time to Complete This Activity

45 minutes

Accreditation and Credit

In support of improving patient care, this activity has been planned and implemented by Washington University School of Medicine in St. Louis, Continuing Medical Education and the Pulmonary Hypertension Association. Washington University School of Medicine in St Louis is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.

Continuing Education Provided By:
Washington University School of Medicine in St. Louis, Continuing Medical Education.

Washington University designates this enduring educational activity for a maximum of 0.75 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Instructions for Earning Credit

This activity is a self-study program. Upon entering the activity, participants should read the text, examine any images and/or multimedia features, and review the content presented within the links provided. Once the course has been reviewed in its entirety, participants will be asked to complete a post-test and evaluation online. Participants must receive a test score of 80% to proceed to the course evaluation; the post-test can be repeated until all questions are answered correctly. All evaluation questions must be completed to receive a certificate of credit. If needed, participants may save their answers and complete the course at a later date. Saved courses can be found by using the "My Courses" link at the top of the page, and then click on "My Classes."

Disclosure Policy

It is the policy of Washington University School of Medicine, Continuing Medical Education, to ensure balance, independence, objectivity and scientific rigor in all its educational activities. All planners, faculty and other persons who may influence the content of this CME activity have disclosed all relevant financial relationships with commercial interests. All disclosures have been reported and are indicated with their presentations. Any potential conflicts were addressed and resolved.

All members of the CME department have nothing to disclose. Speakers are also expected to openly disclose the inclusion of any discussion of any off-label, experimental, or investigational use of drugs or devices in their presentations.

Presentations are expected to be based on evidence that is accepted within the profession of medicine as adequate justification for their indication in the care of patients. All scientific research should conform to the generally accepted standards of experimental design, data collection, and analysis.

These presentations are not an endorsement of any commercial interests. These presentations are the views and experiences of the presenters. The presenters' views do not represent the policy or position of Washington University School of Medicine. Washington University School of Medicine, Continuing Medical Education, is the provider of CME credits.

Disclosures are reported below: 

  1. Todd M. Bull, M.D. has served in Consulting/Advisory Committees for Bayer HealthCare and Liquidia Technologies.
  2. Michael A. Mathier, M.D. has no relevant financial disclosures.
  3. Murali Chakinala, M.D. has received Research Support/Grants from Actelion Pharmaceuticals US, Inc.; Bayer HealthCare; Eiger Biopharmaceuticals Inc.; GeNO; Gilead Sciences, Inc.; GlaxoSmithKline; Medtronic; Reata Pharmaceuticals. He has served as a Consultant for Bayer HealthCare; Gilead Sciences, Inc.; SteadyMed Therapeutics; and United Therapeutics Corporation. He has served on Speakers’ Bureaus for Bayer HealthCare and Gilead Sciences, Inc. 4. Allyson R. Zazulia, M.D. has no relevant financial disclosures.
  4. Michael Patrick Gray, M.P.H. has no relevant financial disclosures.
  5. Rebecca Aune, M.P.A. has no relevant financial disclosures.


The information presented in this activity reflects the views of the faculty only and not necessarily those of the Pulmonary Hypertension Association (PHA), Washington University in St. Louis, or the educational grant providers. All participants should verify the information and data presented before treating patients or utilizing any therapies noted in these materials. No portion of this activity may be reproduced without the expressed written consent of PHA.

Technical Requirements

This course requires an internet browser. For optimum display, please use Mozilla Firefox, Safari or Google Chrome.

Privacy Policy

For information about PHA's privacy policy, visit

This activity is made possible through unrestricted educational grants to the PHA Medical Education Fund from Actelion Pharmaceuticals US, Inc.; Gilead Sciences, Inc.; and United Therapeutics Corporation.

©2017 Pulmonary Hypertension Association, 801 Roeder Road, Suite 1000, Silver Spring, MD 21910. 

Management of PH in the ICU by Todd Bull, MD Cours