Hypoxic pulmonary vasoconstriction: physiology, role in pneumonia and acute respiratory distress syndrome

Abstract

Hypoxic pulmonary vasoconstriction (HPV) refers to the vasoconstriction of the pulmonary circulation in response to alveolar hypoxia. Its alteration plays an important role in the gas exchange disorders seen in pneumonia and acute respiratory distress syndrome. VPH is primarily stimulated by a reduction in alveolar oxygen pressure, but also by a reduction in venous oxygen pressure. HPV is enhanced by hypercapnia and modulated by many drugs in clinical practice. However, no intervention specifically targeting HPV has yet demonstrated a benefit on major patient-centered outcomes. The development of new tools enabling the study of HPV at the patient's bedside could enable us to better target patients benefiting from HPV modulation.