![]() This article will summarize the physiology of HPV and discuss the relevance of the reflex to the clinical practice of anaesthesia and intensive care in adults. It is an important mechanism for matching of regional perfusion and ventilation in the lung. ![]() Hypoxic pulmonary vasoconstriction (HPV) is a reflex contraction of vascular smooth muscle in the pulmonary circulation in response to a low regional partial pressure of oxygen. Managing acute severe pulmonary hypertension needs careful consideration to ventilation, fluid management, inotropes, and vasopressors. Inhaled anaesthetic agents inhibit HPV in a dose-dependent fashion, but at clinically relevant doses the currently used agents have a negligible effect. HPV increases pulmonary vascular resistance and pulmonary artery pressure, which can precipitate right heart failure. Physiological factors that influence HPV include pH, P CO 2, temperature, age, and iron status. Hypoxic pulmonary vasoconstriction (HPV) helps to match regional perfusion to ventilation in the lungs.
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