Choque neurogênico: manejo clínico e suas particularidades na sala de emergência

Resumo

O impacto do choque neurogênico na traumatologia não é desprezível. Trata-se de uma condição importante, associada a lesão do neuroeixo, podendo ser medular e/ou cerebral. O conhecimento de sua fisiopatologia vem aumentando, permitindo assim a redução de sua morbimortalidade com intervenções mais precisas e eficazes já na sala de emergência. Neste artigo de revisão, o autor apresenta informações atuais sobre o manejo do choque neurogênico na sala de emergência, destacando medidas neuroprotetoras que impactem positivamente em sua evolução. Diversas medidas farmacológicas ainda são questionáveis, necessitando novos estudos prospectivos e aleatórios. O momento adequado da intervenção neurocirúrgica também é discutível. Claramente, as medidas iniciais realizadas na sala de emergência são fundamentais para garantir condições adequadas a neuroplasticidade e reabilitação neuronal.

Palavras-chave

choque neurogênico - choque medular - cuidados intensivos - trauma raquimedular - traumatismo cranioencefálico - neurotrauma

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