hypercapnia

So what is going to push their pulmonary vascular resistance up or their PVR up? I think these questions are board favorites.

Things like hypoxemia, hypercarbia, acidosis, hypothermia, and catecholamine release, like if the patient has pain or anxiety or has light anesthesia.

If you have high airway pressures from positive pressure ventilation and PEEP, that's going to raise it too.

And of your anesthetic drugs, drugs like nitrous oxide is going to raise your PVR.

This includes drugs like sildenafil, the Viagra, or any kind of continuous prostacyclin infusions.

If the patient's having a minor procedure, doing things like peripheral nerve blocks with MAC are a good choice.

Just remember that if you over-sedate the patient, it's going to cause hypercarbia, which is going to increase or raise PVR.

I've seen this happen a couple times in patients where patients undergo MAC, but are way too deeply sedated.