ICU · Resuscitation & shock

Neurogenic Shock (Spinal Cord Injury)

Also known as Neurogenic shock · Spinal shock · Spinal cord injury shock · Distributive shock spinal · MAP target spinal cord

Neurogenic shock — the loss of supraspinal sympathetic control after spinal cord injury at or above T6. The vasodilation with venous pooling (the warm, the dry) plus the bradycardia (the unopposed vagal). The MAP target: the traditional 85 to 90 mmHg for up to seven days, refined by the 2024 AO Spine guideline to 75 to 80 mmHg as the lower limit and 90 to 95 mmHg as the upper limit for 3 to 7 days. Noradrenaline commonly preferred where a vasopressor is needed; atropine first-line for symptomatic bradycardia. Distinguish from the hypovolaemic (the warm plus the dry versus the cool plus the clammy) and from spinal shock (the neurological phenomenon).