2011-03最新HRV臨床論文摘要 

神經性休克(Neurogenic shock)

神經性休克(Neurogenic shock):頸椎或上胸椎的傷害會造成交感神經功能喪失而導致低血壓;若在較高位的頸椎受損其低血壓會伴隨心搏過慢(bradycardia)
Neurogenic shock
From Wikipedia, the free encyclopedia

http://en.wikipedia.org/wiki/Neurogenic_shock



Neurogenic shock is a distributive type of shock resulting in hypotension, occasionally with bradycardia, that is attributed to the disruption of the autonomic pathways within the spinal cord. Hypotension occurs due to decreased systemic vascular resistance resulting in pooling of blood within the extremities lacking sympathetic tone. Bradycardia results from unopposed vagal activity and has been found to be exacerbated by hypoxia and endobronchial suction.[1] Neurogenic shock can result from severe central nervous system damage (brain injury, cervical or high thoracic spinal cord).[2] In more simple terms: the trauma causes a sudden loss of background sympathetic stimulation to the blood vessels. This causes them to relax (vasodilation)[3] resulting in a sudden decrease in blood pressure (secondary to a decrease in peripheral vascular resistance).

Neurogenic shock can be a potentially devastating complication, leading to organ dysfunction and death if not promptly recognized and treated. It is not to be confused with spinal shock, which is not circulatory in nature.

[edit] Treatment
Fluid is always the initial treatment of shock, especially since concomitant hemorrhagic shock must be excluded following trauma. Most institutions will additionally utilize pressor agents to achieve hemodynamic stability.
Dopamine (Intropin) is often used either alone or in combination with other inotropic agents.
Vasopressin (antidiuretic hormone [ADH])[4]
Certain vasopressors (ephedrine, norepinephrine). Phenylephrine should be avoided as it can worsen bradycardia often seen in neurogenic shock.
Atropine (speeds up heart rate and cardiac output)