华西重症医学网

右美托咪定对于肌张力增高发作性自主神经功能不稳的治疗

作者:管理员 来源: 日期:2015/12/27 16:23:22 人气:
Abstract
Introduction A 38-year-old man with severe head trauma complicated by paroxysmal severe intracranial pressure elevation associated with tachypnea, tachycardia, diaphoresis,
and extensor posturing was diagnosed as suffering from paroxysmal autonomic instability with dystonia (PAID). These events were unresponsive to standard medical therapy, which included morphine, fentanyl,labetalol, lorazepam, metoprolol, and clonidine.Methods A trial treatment with dexmedetomidine, a central acting alpha2-agonist, to control symptoms of

PAID was initiated 12 days after injury. PAID-related events subsided during the 72-h infusion protocol of 0.2–0.7 mcg/kg/h. No further events were noted after termination of the 72-h infusion.Conclusions Dexmedetomidine may be a novel pharmacologic agent to aid in abrogating PAID.

Keywords Dexmedetomidine  Sympathetic storming Paroxysmal autonomic instability with dystonia Diencephalic seizure  Dysautonomia  Traumatic brain injury


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