Use of midodrine and fludrocortisone in neurogenic shock: A case report.

Ann Med Surg (Lond)

Department of Critical Care, Grande International Hospital, Kathmandu, Nepal.

Published: October 2021

Our case report includes a 42 year old male who had C6-C7 fracture dislocation with complete spinal cord injury following a motor vehicle accident. The patient underwent combined anterior and posterior fixation of the cervical spine. However, the patient had hypotension as a part of neurogenic shock and required vasopressor to maintain mean arterial pressure. The patient was treated in Intensive Care Unit with noradrenaline infusion to maintain mean arterial pressure but it was really challenging to stop the vasopressor. The patient was started on oral Midodrine and Fludrocortisone; vasopressor dose was tapered and finally stopped.

Download full-text PDF

Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8463817PMC
http://dx.doi.org/10.1016/j.amsu.2021.102811DOI Listing

Publication Analysis

Top Keywords

midodrine fludrocortisone
8
neurogenic shock
8
case report
8
maintain arterial
8
arterial pressure
8
fludrocortisone neurogenic
4
shock case
4
report case
4
report includes
4
includes year
4

Similar Publications

Aim: The study aimed to assess the haemodynamic effects of fludrocortisone and midodrine, alone or combined, in patients with recurrent syncope and/or symptoms due to hypotension and ≥ 1 daytime systolic blood pressure (SBP) drop < 90 mmHg or ≥ 2 daytime SBP drops < 100 mmHg recorded by 24-h ambulatory blood pressure monitoring (ABPM1).

Method: A total of 53 patients (mean age, 40.9 ± 18.

View Article and Find Full Text PDF

Purpose: Orthostatic hypotension (OH) is a common manifestation of Parkinson's disease (PD). Factors including autonomic dysfunction from the disease, use of PD medications, comorbidities, and aging can contribute to an increased risk of OH, which can be detrimental to patients' quality of life. Maintaining a fine balance to prevent harm related to OH and retain the benefit medications used to treat PD is crucial.

View Article and Find Full Text PDF

Diabetic autonomic neuropathy (DAN) and its associated cardiovascular autonomic neuropathy (CAN) can lead to potentially fatal complications. We analyzed two distinct cases of DAN/CAN based on comprehensive cardiovascular autonomic reflex tests (CARTs). Case 1 involves a 27-year-old patient with T1DM suffering from recurrent severe hypoglycemic unawareness due to DAN.

View Article and Find Full Text PDF

Postural orthostatic tachycardia syndrome (POTS) is a chronic illness with unknown mortality and high morbidity, often diagnosed in the adolescent years. Published literature regarding POTS primarily focuses on the adult population, and guidance on treatment in pediatrics is sparse. The purpose of this clinical review is to evaluate the current literature on the management of POTS in pediatric patients.

View Article and Find Full Text PDF

Endocrinopathies following immunotherapy have infrequently been documented in the literature. Adrenal insufficiency is a rare consequence of pembrolizumab immunotherapy, with incidence reported to be between 0.98 and 1.

View Article and Find Full Text PDF

Want AI Summaries of new PubMed Abstracts delivered to your In-box?

Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!