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Current Anesthesiology Reports

, Volume 8, Issue 1, pp 86–93 | Cite as

Recent Advances in the Use of Vasopressors and Inotropes in Neurotrauma

  • Peter Lax
  • Arman Dagal
Anesthesia for Trauma (TE Grissom, Section Editor)
Part of the following topical collections:
  1. Anesthesia for Trauma

Abstract

Purpose of review

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 findings

There 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).

Summary

Neuroanesthesia 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.

Keywords

Inotrope Vasopressor Neuroanesthesia Trauma Head injury Spinal cord injury 

Notes

Compliance with Ethical Standards

Conflict of Interest

Peter Lax and Arman Dagal declare they have no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Copyright information

© Springer 2018

Authors and Affiliations

  1. 1.RAF Tactical Medical Wing, Brize NortonCartertonUK
  2. 2.Department of Anesthesiology and Pain Medicine, Harborview Medical CenterUniversity of WashingtonSeattleUSA

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