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Recent Advances in the Use of Vasopressors and Inotropes in Neurotrauma

  • Anesthesia for Trauma (TE Grissom, Section Editor)
  • Published:
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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.

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

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Authors and Affiliations

  1. RAF Tactical Medical Wing, Brize Norton, Carterton, Oxfordshire, OX18 3LX, UK

    Peter Lax

  2. Department of Anesthesiology and Pain Medicine, Harborview Medical Center, University of Washington, Seattle, WA, USA

    Arman Dagal

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

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Lax, P., Dagal, A. Recent Advances in the Use of Vasopressors and Inotropes in Neurotrauma. Curr Anesthesiol Rep 8, 86–93 (2018). https://doi.org/10.1007/s40140-018-0255-8

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