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Neurogenic shock

MedGen UID:
107781
•Concept ID:
C0544617
•
Pathologic Function
Synonyms: Neurogenic Shock; Vasogenic Shock
SNOMED CT: Neurogenic shock (129577007)

Definition

Shock resulting from neurogenic vasodilation, which can be produced by cerebral trauma or hemorrhage, spinal cord injury, deep general or spinal anesthesia, or toxic central nervous system depression. [from NCI]

Term Hierarchy

CClinical test,  RResearch test,  OOMIM,  GGeneReviews,  VClinVar  
  • CROGVNeurogenic shock

Professional guidelines

PubMed

Acute Management of Cervical Spinal Cord Injuries.
Hunt A, McQuillan KA
Crit Care Nurs Clin North Am 2023 Jun;35(2):119-128. Epub 2023 Mar 27 doi: 10.1016/j.cnc.2023.02.004. PMID: 37127369
Contemporary hemodynamic management of acute spinal cord injuries with intravenous and enteral vasoactive agents: A narrative review.
Iovine JA, Villanueva RD, Werth CM, Hlavacek NL, Rollstin AD, Tawil I, Sarangarm P
Am J Health Syst Pharm 2022 Sep 7;79(18):1521-1530. doi: 10.1093/ajhp/zxac164. PMID: 35677966
Critical care and perioperative management in traumatic spinal cord injury.
Stevens RD, Bhardwaj A, Kirsch JR, Mirski MA
J Neurosurg Anesthesiol 2003 Jul;15(3):215-29. doi: 10.1097/00008506-200307000-00009. PMID: 12826969

Recent clinical studies

Etiology

Damage control approach to refractory neurogenic shock: a new proposal to a well-established algorithm.
Parra MW, Ordoñez CA, Mejia D, Caicedo Y, Lobato JM, Castro OJ, Uribe JA, Velásquez F
Colomb Med (Cali) 2021 Apr-Jun;52(2):e4164800. Epub 2021 Jun 30 doi: 10.25100/cm.v52i2.4800. PMID: 34908624Free PMC Article
Presentation of neurogenic shock within the emergency department.
Taylor MP, Wrenn P, O'Donnell AD
Emerg Med J 2017 Mar;34(3):157-162. Epub 2016 Oct 3 doi: 10.1136/emermed-2016-205780. PMID: 27697845
Vascular dysfunctions following spinal cord injury.
Popa C, Popa F, Grigorean VT, Onose G, Sandu AM, Popescu M, Burnei G, Strambu V, Sinescu C
J Med Life 2010 Jul-Sep;3(3):275-85. PMID: 20945818Free PMC Article
Bradycardia in neurosurgery.
Agrawal A, Timothy J, Cincu R, Agarwal T, Waghmare LB
Clin Neurol Neurosurg 2008 Apr;110(4):321-7. Epub 2008 Mar 7 doi: 10.1016/j.clineuro.2008.01.013. PMID: 18329164
The pathophysiology of shock.
Skowronski GA
Med J Aust 1988 Jun 6;148(11):576-9, 582-3. PMID: 3287110

Diagnosis

Neurogenic Shock: A Case Report.
North N, Adams A
J Emerg Nurs 2023 Jul;49(4):495-498. doi: 10.1016/j.jen.2023.04.003. PMID: 37393074
Incidence and Natural Progression of Neurogenic Shock after Traumatic Spinal Cord Injury.
Ruiz IA, Squair JW, Phillips AA, Lukac CD, Huang D, Oxciano P, Yan D, Krassioukov AV
J Neurotrauma 2018 Feb 1;35(3):461-466. Epub 2017 Dec 18 doi: 10.1089/neu.2016.4947. PMID: 29141498
Update on traumatic acute spinal cord injury. Part 1.
Galeiras Vázquez R, Ferreiro Velasco ME, Mourelo Fariña M, Montoto Marqués A, Salvador de la Barrera S
Med Intensiva 2017 May;41(4):237-247. Epub 2017 Feb 1 doi: 10.1016/j.medin.2016.11.002. PMID: 28161028
Spinal injuries.
Mackenzie R
J R Army Med Corps 2002 Jun;148(2):163-71. doi: 10.1136/jramc-148-02-11. PMID: 12174560
The pathophysiology of shock.
Skowronski GA
Med J Aust 1988 Jun 6;148(11):576-9, 582-3. PMID: 3287110

Therapy

Emergency Neuropharmacology.
DeWitt KM, Porter BA
Emerg Med Clin North Am 2021 Feb;39(1):133-154. Epub 2020 Nov 5 doi: 10.1016/j.emc.2020.09.008. PMID: 33218654
Vasopressor support in managing acute spinal cord injury: current knowledge.
Yue JK, Tsolinas RE, Burke JF, Deng H, Upadhyayula PS, Robinson CK, Lee YM, Chan AK, Winkler EA, Dhall SS
J Neurosurg Sci 2019 Jun;63(3):308-317. Epub 2017 Mar 1 doi: 10.23736/S0390-5616.17.04003-6. PMID: 28252264
Update on traumatic acute spinal cord injury. Part 1.
Galeiras Vázquez R, Ferreiro Velasco ME, Mourelo Fariña M, Montoto Marqués A, Salvador de la Barrera S
Med Intensiva 2017 May;41(4):237-247. Epub 2017 Feb 1 doi: 10.1016/j.medin.2016.11.002. PMID: 28161028
Milrinone therapy for enterovirus 71-induced pulmonary edema and/or neurogenic shock in children: a randomized controlled trial.
Chi CY, Khanh TH, Thoa le PK, Tseng FC, Wang SM, Thinh le Q, Lin CC, Wu HC, Wang JR, Hung NT, Thuong TC, Chang CM, Su IJ, Liu CC
Crit Care Med 2013 Jul;41(7):1754-60. doi: 10.1097/CCM.0b013e31828a2a85. PMID: 23685637
Terlipressin in brain-death donors.
Piazza O, Scarpati G, Rispoli F, Iannuzzi M, Tufano R, De Robertis E
Clin Transplant 2012 Nov-Dec;26(6):E571-5. Epub 2012 Nov 2 doi: 10.1111/ctr.12038. PMID: 23121213

Prognosis

Incidence and Natural Progression of Neurogenic Shock after Traumatic Spinal Cord Injury.
Ruiz IA, Squair JW, Phillips AA, Lukac CD, Huang D, Oxciano P, Yan D, Krassioukov AV
J Neurotrauma 2018 Feb 1;35(3):461-466. Epub 2017 Dec 18 doi: 10.1089/neu.2016.4947. PMID: 29141498
Update on traumatic acute spinal cord injury. Part 1.
Galeiras Vázquez R, Ferreiro Velasco ME, Mourelo Fariña M, Montoto Marqués A, Salvador de la Barrera S
Med Intensiva 2017 May;41(4):237-247. Epub 2017 Feb 1 doi: 10.1016/j.medin.2016.11.002. PMID: 28161028
Spinal shock. Assessment & treatment of spinal cord injuries & neurogenic shock.
Fox AD
JEMS 2014 Nov;39(11):64-7. PMID: 25630163
Cardiovascular and urological dysfunction in spinal cord injury.
Hagen EM, Faerestrand S, Hoff JM, Rekand T, Gronning M
Acta Neurol Scand Suppl 2011;(191):71-8. doi: 10.1111/j.1600-0404.2011.01547.x. PMID: 21711260
Cardiac dysfunctions following spinal cord injury.
Grigorean VT, Sandu AM, Popescu M, Iacobini MA, Stoian R, Neascu C, Strambu V, Popa F
J Med Life 2009 Apr-Jun;2(2):133-45. PMID: 20108532Free PMC Article

Clinical prediction guides

A Two Parameters for the Evaluation of Hypovolemia in Patients with Septic Shock: Inferior Vena Cava Collapsibility Index (IVCCI), Delta Cardiac Output.
Kaçar CK, Uzundere O, Yektaş A
Med Sci Monit 2019 Oct 29;25:8105-8111. doi: 10.12659/MSM.919434. PMID: 31659997Free PMC Article
Vasopressor support in managing acute spinal cord injury: current knowledge.
Yue JK, Tsolinas RE, Burke JF, Deng H, Upadhyayula PS, Robinson CK, Lee YM, Chan AK, Winkler EA, Dhall SS
J Neurosurg Sci 2019 Jun;63(3):308-317. Epub 2017 Mar 1 doi: 10.23736/S0390-5616.17.04003-6. PMID: 28252264
Bradycardia in neurosurgery.
Agrawal A, Timothy J, Cincu R, Agarwal T, Waghmare LB
Clin Neurol Neurosurg 2008 Apr;110(4):321-7. Epub 2008 Mar 7 doi: 10.1016/j.clineuro.2008.01.013. PMID: 18329164
Cervical spinal cord injury and the need for cardiovascular intervention.
Bilello JF, Davis JW, Cunningham MA, Groom TF, Lemaster D, Sue LP
Arch Surg 2003 Oct;138(10):1127-9. doi: 10.1001/archsurg.138.10.1127. PMID: 14557131
Critical care and perioperative management in traumatic spinal cord injury.
Stevens RD, Bhardwaj A, Kirsch JR, Mirski MA
J Neurosurg Anesthesiol 2003 Jul;15(3):215-29. doi: 10.1097/00008506-200307000-00009. PMID: 12826969

Recent systematic reviews

A systematic review of intensive cardiopulmonary management after spinal cord injury.
Casha S, Christie S
J Neurotrauma 2011 Aug;28(8):1479-95. Epub 2010 Apr 8 doi: 10.1089/neu.2009.1156. PMID: 20030558Free PMC Article

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