Contemporary hemodynamic management of acute spinal cord injuries with intravenous and enteral vasoactive agents: A narrative review.

Purpose: The pathophysiology and hemodynamic management of acute spinal cord injuries, including the use of intravenous and enteral vasoactive agents, are reviewed.

Summary: Spinal cord injuries are devastating neurological insults that in the acute setting lead to significant hemodynamic disturbances, including hypotension and bradycardia, that are influenced by the level of injury. High thoracic (usually defined as at or above T6) and cervical injuries often manifest with hypotension and bradycardia due to destruction of sympathetic nervous system activity and unopposed vagal stimulation to the myocardium, whereas lower thoracic injuries tend to result in hypotension alone due to venous pooling.

Family presence during brain death evaluation: a randomized controlled trial*.

Objective: To evaluate if a family presence educational intervention during brain death evaluation improves understanding of brain death without affecting psychological distress.

Design: Randomized controlled trial.

Setting: Four ICUs at an academic tertiary care center.