Neurogenic Shock

Question 1

What is neurogenic shock

Answer 1

Disruption of autonomic nervous system-hemodynamic phenomenon
*vasodilation, pooling of blood

Question 2

What is important to keep in mind about neurogenic shock

Answer 2

Do not assume neurogenic shock alone until alternate source of hemorrhage is excluded

Question 3

What are the clinical features of neurogenic shock

Answer 3

Hypotension
*due to massive vasodilation
Bradycardia
*due to unopposed parasympathic stimulation
Poikilothermia (warm skin)
*due to inability to regulate temperature

Question 4

What is the treatment of neurogenic shock

Answer 4

Aggressive evaluation of other potential cuases of shock
1. Airway support
2. Fluid challenge
*30 cc/kg with goal of MAP >90
3. Vasopressors is volume replacement unsuccessful

Question 5

What can the trendelenburg be helpful for

Answer 5

In cases of neurogenic shock
*avoid in TBI patients