Abstract
Objective: Neurogenic shock considered a distributive type of shock secondary to loss of sympathetic
outflow to the peripheral vasculature. In this study, we examine the hemodynamic profiles of a series of
trauma patients with a diagnosis of neurogenic shock.
Methods: Hemodynamic data were collected on a series of trauma patients determined to have spinal
cord injuries with neurogenic shock. A well-established integrated computer model of human
physiology was used to analyze and categorize the hemodynamic profiles from a system analysis
perspective. A differentiation between these categories was presented as the percent of total patients.
Results: Of the 9 patients with traumatic neurogenic shock, the etiology of shock was decrease in
peripheral vascular resistance (PVR) in 3 (33%; 95% confidence interval, 12%-65%), loss of vascular
capacitance in 2 (22%; 6%-55%) and mixed peripheral resistance and capacitance responsible in 3
(33%; 12%-65%), and purely cardiac in 1 (11%; 3%-48%). The markers of sympathetic outflow had no
correlation to any of the elements in the patients' hemodynamic profiles.
Conclusions: Results from this study suggest that hypotension of neurogenic shock can have multiple
mechanistic etiologies and represents a spectrum of hemodynamic profiles. This understanding is
important for the treatment decisions in managing these patients.