What is your induction approach for a patient with pulmonary hypertension?

To keep it simple: Assuming the patient has good RV systolic function and good EF.

I ask because I’ve had colleagues who insist that vasopressin is the only safe pressors to give. Others say that a1 doesn’t exist in pulmonary vasculature enough to make giving phenylepherine dangerous. Others say norepi doesn’t increase PVR significantly as well.

So genuine question: what is your induction approach for GETA non-cardiac surgery for a patient with severe pulmonary HTN and good RV function? I typically do a good fluid bolus in preop if I can to help with preload, gentle induction with propofol, and half a unit of vaso. Where I trained, my cardiac and general attendings rarely used etomidate even on sick hearts or pHTN, so I rarely use it as well.

Also, what is your approach to EGDs/colonoscopies on the same patient population?