Place of Atropine and Vasoactive Drugs in Hemodynamic and Rhythmic Complications of Cervical Spine Trauma
SM Medjadi1*, L Cherfi2, H Brahimi3 and N Taleb Bendiab4
1Department of Anesthesia and Intensive Care, Aboubekr Belkaïd University, Tlemcen, Algeria
2Department of Anesthesia and Intensive Care, Hospital Center Henri Mondor, Aurillac, France
3Department of Infectious Diseases, Aboubekr Belkaïd University, Tlemcen, Algeria
4Department of Cardiology, Aboubekr Belkaïd University, Tlemcen, Algeria
*Corresponding Author: SM Medjadi, Department of Anesthesia and Intensive Care, Aboubekr Belkaïd University, Tlemcen, Algeria.
December 09, 2021; Published: February 15, 2022
Objectives: The aim of this work is to demonstrate the importance of the earliest atropine’s introduction and vasoactive drugs as preventive therapy for the occurrence of hemodynamic and rhythmic complications, which most often severely hamper the prognosis of cervical spine trauma patients.
Patients and Methods: Exhaustive descriptive-type study with prospective collection, carried out over a period of three and a half years at the level of several structures of the Tlemcen University Hospital, namely medico-surgical emergencies, multipurpose resuscitation and neurosurgery departments. It focuses on cervical spine trauma patients treated from the scene of the accident to the neurosurgery and/or medico-surgical intensive care unit at Tlemcen University Hospital. All were admitted for cervical spine trauma, whatever the level reached, whatever the mechanism of the accident, whatever the treatment decision, with or without neurological lesions, with or without signs of seriousness on admission and over 16 years of age.
Results: The initial management in intensive care and in a dechocking unit for vegetative disorders was indicated on admission in 25% of patients. Cardiac arrest recovered in three patients on admission to medico-surgical emergencies. An injection of Atropine® on admission was performed in 18.75% of patients, but also vasoconstrictor drugs in 15.62%. A combination of vasoactive drugs and Atropine® were required in 7.81% of our patients; 33 of them had hemodynamic disturbances and 20 were in collapse requiring the use of vasoconstrictor drugs.
Conclusion: Our study allowed us to study and analyze the main hemodynamic and rhythmic changes occurring during cervical spine trauma. Survival was 7 ± 3.71 days for the patients who had bradycardia, and 29 ± 6.13 days for those who had kept a normal heart rhythm (P = 0.000). Maintaining a stable heart rate and hemodynamic state upon admission remains the primary care physician's priority in order to increase the chances of survival for this type of patient.
Keywords: Cervical Spine Trauma; Neurogenic Shock; Atropine; Vasoactive Drugs; Hemodynamic Complications
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