Neurogenic shock is characterized by:
Correct Answer: Hypotension and bradycardia
Description: Ans. d. Hypotension and bradycardia (Ref: Harrison 19/e p1750, 18/e p2222. 2219)Neurogenic shock is characterized by hypotension and bradycardia."Neurogenic shock: In addition to arteriolar dilation, venodilation causes pooling in the venous system, which decreases venous return and cardiac output. Harrison 18/e p2222, 2219Neurogenic ShockInterruption of sympathetic vasomotor input after a high cervical spinal cord injury, inadvertent cephalad migration of spinal anesthesia, or devastating head injury may result in neurogenic shock.In addition to arteriolar dilation, venodilation causes pooling in the venous system, which decreases venous return and cardiac outputQ.The extremities are often warm, in contrast to the usual sympathetic vasoconstriction-induced coolness in hypovolemic or cardiogenic shockQ.Treatment:Treatment involves a simultaneous approach to the relative hypovolemia and to the loss of vasomotor tone.Excessive volumes of fluid may be required to restore normal hemodynamics if given alone.Once hemorrhage has been ruled out, norepinephrine or a pure alpha-adrenergic agent (phenylephrine) may be necessaryPhysiologic Characteristics of the Various Forms of ShockType of ShockCVP and PCWPCardiac OutputSVRVenous O2 SaturationHypovolemic ||||Cardiogenic||||Septic Hyperdynamic|||||Hypodynamic||||||Traumatic||||||Neurogenic||||Hypoadrenal|||=||
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