- Neurogenic shock is a type of shock caused by the sudden loss of the autonomic nervous system signals to the smooth muscle in vessel walls.
- This results in loss of background sympathetic stimulation, which is responsible for maintenence of tone of blood vessels.
- As a result of loss of vascular tone, the vessels suddenly relax resulting in a sudden decrease in peripheral vascular resistance and decreased blood pressure.
Causes of Neurogenic Shock
Failure of the autonomic nervous system can arise from
- Regional anesthesia
- Injuries to the spinal cord (cervical spine and upper thoracic spine)
- Administration of autonomic blocking agents.
Symptoms and Signs of Neurogenic Shock
- Warm and Dry extremitis
- Peripheral vasodilation
- Decreased cardiac output
Treatment of Neurogenic Shock
- Vasopressin (antidiuretic hormone)
- Vasopressors like ephedrine, norepinephrine
- Phenylephrine is used as first line or in patients who do not respond adequately to dopamine.
- Atropine if bradycardia is severe.
- Peripheral resistance is decreased in Neurogenic shock
- Neurogenic shock is characterized by Decreased peripheral vascular resistance
- Feature of neurogenic shock is Bradycardia and hypotension
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