What Is Neurogenic Shock?

Neurogenic shock is a serious impediment to the regulation of arterial resistance, loss of vascular tone, causing vasodilation, resulting in a decrease in peripheral vascular resistance, and effective hypovolemic shock. More common in severe trauma, severe pain (brain cavity, abdominal cavity or pericardial puncture, etc.) stimulation, as well as high spinal anesthesia or injury, rapid onset, timely diagnosis, treatment and good prognosis. Under normal circumstances, the vascular movement center continuously sends out impulses along the outgoing sympathetic constriction fibers to reach the small blood vessels throughout the body, making it maintain a certain tension. When the vasomotor center is inhibited or the outgoing sympathetic constrictive vascular fibers are blocked, the small blood vessels will expand due to the loss of tension. As a result, the peripheral vascular resistance will be reduced, and a large amount of blood will stagnate in the microcirculation and return the blood volume. A sharp decrease in blood pressure leads to neurogenic shock. The pathophysiological changes and pathogenesis of such shocks are relatively simple, and the prognosis is also good. Sometimes they can heal without treatment, and some quickly improve after the application of vasoconstrictor drugs. (Li Yonghong) ^[1]

Neurogenic shock

Neurogenic shock is a serious impediment to the regulation of arterial resistance, loss of vascular tone, causing vasodilation, resulting in a decrease in peripheral vascular resistance, and effective hypovolemic shock. More common in severe trauma, severe pain (brain cavity, abdominal cavity or pericardial puncture, etc.) stimulation, as well as high spinal anesthesia or injury, rapid onset, timely diagnosis, treatment and good prognosis. Under normal circumstances, the vascular movement center continuously sends out impulses along the outgoing sympathetic constriction fibers to reach the small blood vessels throughout the body, making it maintain a certain tension. When the vasomotor center is inhibited or the outgoing sympathetic constrictive vascular fibers are blocked, the small blood vessels will expand due to the loss of tension. As a result, the peripheral vascular resistance will be reduced, and a large amount of blood will stagnate in the microcirculation and return the blood volume. A sharp decrease in blood pressure leads to neurogenic shock. The pathophysiological changes and pathogenesis of such shocks are relatively simple, and the prognosis is also good. Sometimes they can heal without treatment, and some quickly improve after the application of vasoconstrictor drugs. (Li Yonghong) ^[1]

1. Dizziness, pale, and sweating;

2. Pain, nausea, and vomiting;

3. Chest tightness, palpitations, and difficulty breathing;

4. Faster pulse and lower blood pressure.

Diagnose based on

1. Have strong nerve stimulation, such as trauma, severe pain.

2. Dizziness, pale, sweating, pain, nausea.

3. Chest tightness, palpitations, and difficulty breathing.

4. Fine pulse and decreased blood pressure.

Neurogenic shock treatment principles

1. Remove the nerve stimulus and lie flat.

2. Immediately subcutaneously or intramuscularly inject epinephrine.

3. Quickly replenish effective blood volume.

4. Application of adrenal corticosteroids.

5. Maintain normal blood pressure.

6. Etiology treatment.

Principles of medication for neurogenic shock

1. When neurogenic shock occurs, immediately use epinephrine, quickly replenish effective blood volume, and apply dextran.

2. Patients with a severe condition can apply dexamethasone.

3. The systolic blood pressure is below 80mmHg, and dopamine or m-hydroxylamine should be used.

4. Use pain medication as appropriate.