Copyright
©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Crit Care Med. Dec 9, 2025; 14(4): 111434
Published online Dec 9, 2025. doi: 10.5492/wjccm.v14.i4.111434
Published online Dec 9, 2025. doi: 10.5492/wjccm.v14.i4.111434
Pathophysiology and management of right ventricular failure in critically ill patients: A narrative review
Riley Kermanian, Michael I Lewis, Yuri Matusov, Division of Pulmonary and Critical Care Medicine, Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA 90048, United States
Harpreet Dosanjh, Department of Internal Medicine, Los Robles Regional Medical Center, Thousand Oaks, CA 91360, United States
Author contributions: Kermanian R and Dosanjh H performed the literature review and wrote the initial draft of the manuscript; Lewis MI provided expert review of the manuscript and contributed to manuscript revisions; Matusov Y conceptualized and oversaw the project and contributed to manuscript revisions.
Conflict-of-interest statement: Kermanian R, Dosanjh H, and Lewis MI have no conflicts of interest or disclosures. Matusov Y has no conflicts of interest, has received research funding to the institution from Mallickrodt, Tenax, Penumbra, and Aerovate. The present work is unfunded.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Yuri Matusov, MD, FACP, ATSF, Division of Pulmonary and Critical Care Medicine, Department of Medicine, Cedars-Sinai Medical Center, 8700 Beverly Blvd., Los Angeles, CA 90048, United States. yuri.matusov@cshs.org
Received: July 1, 2025
Revised: August 5, 2025
Accepted: November 6, 2025
Published online: December 9, 2025
Processing time: 150 Days and 15.4 Hours
Revised: August 5, 2025
Accepted: November 6, 2025
Published online: December 9, 2025
Processing time: 150 Days and 15.4 Hours
Core Tip
Core Tip: Right ventricular (RV) failure is a common and complex problem among critically ill patients. The management of RV failure is highly dependent on its underlying etiology, chronicity, and resource availability. General principles of RV failure include maintenance of adequate systemic blood pressure, reduction of RV afterload, provision of inotropic support, correction of acidosis and hypoxemia, and management of the underlying precipitating condition. This review provides a comprehensive and practical approach to RV failure in critical illness, highlighting common scenarios and summarizing the available evidence.