Recent Advances in the Use of Vasopressors and Inotropes in Neurotrauma

This article aims to identify optimum use of inotropes and vasopressors in the context of head and spinal cord injury, both isolated and in polytrauma patients.Recent findingsThere have been relatively few recent publications related to vasopressors and hemodynamic targets in neurotrauma. Most of the literature refers to targeting blood pressures and cerebral perfusion pressures above the recommendations in the latest iterations of the Brain Trauma Foundation guidelines. As a consequence, the rate of complications and side effects are higher at these pressures (e.g. increases in intracranial pressure with higher dose dopamine).SummaryNeuroanesthesia remains an exacting discipline and there is currently no definitive evidence to suggest an ideal cardiovascular agent, especially in a group that is both heterogeneous in demographics and injury pattern. Attention to multiple smaller details is likely more important than choosing one agent over another to maintain blood pressure.

Source: Current Anesthesiology Reports - February 3, 2018 Category: Anesthesiology Source Type: research