All right, so welcome back to the Internet Book of Critical Care podcast.

I'm here with Adam Thomas, and we're going to talk about inhaled pulmonary vasodilators.

Josh, this is going to be a fun chapter.

And for everyone that was paying attention at H&R 2020 this year, this is working on a big component of that talk, isn't it? Yeah, although hopefully

it'll be a bit more fun. Fun, Josh? You have fun with these things? No. Okay, so today we're

going to cover the workhorses that we're all aware of, oxygen, male-renone, and then nitric oxide

and epiproprostinoone we're going to throw the

nucate on the block that has been standing on the curb for generations nitroglycerin

and then we'll talk about the deep physiology and indication so let's turn this on

its head start off physiological effects here what is the point of using

inhaled pulmonary vasidilators when somebody's

got a low oxygen? The most basic thing that inhaled pulmonary vasidilators do is they improve

ventilation profusion matching. So ideally, you want the most profusion to go to the best

functioning alveoli that are getting the best ventilation. So if you inhale a pulmonary vasodilator,

that basically vasodilates the best functioning alveoli the inhale a pulmonary vasodilator, that basically

vasodilates the best functioning alveoli the most, and that pulls the blood profusion to the best

alveoli, thereby improving ventilation profusion matching. And this is an important thing to realize

because sometimes folks think, oh, like, you know, we can't give inhale dipoprosanol for some reason.

Maybe we can give intravenous epiprosanol. Oh, no. And that would actually get the opposite.

Exactly.

No.

Don't do it.

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