With increasing survival comes morbidity. Pulmonary hypertension in the critical care population represents a secondary disease of myriad pathologies for children and adults. Whilst often cardiac failure or respiratory disease complicated by pulmonary hypertension, the exact aetiology of secondary pulmonary hypertension can be a diagnostic challenge. Yet an understanding of the pathophysiological basis for pulmonary hypertension may allow for patient guided therapy and predictions of reversibility.

With pulmonary vasodilators of various mechanistic and non-specific sites of action backed by limited disease specific clinical evidence, are we in the jungle treating secondary pulmonary hypertension or can one management regime encompass all critical care patients?