What is the recommended treatment for neurogenic shock?

The recommended treatment for neurogenic shock primarily involves the administration of fluids and a medication that can effectively increase vascular tone. In this case, phenylephrine and fluids are appropriate due to the nature of neurogenic shock, which results from the loss of sympathetic tone leading to vasodilation, hypotension, and bradycardia.

Phenylephrine is a selective alpha-1 adrenergic agonist that directly constricts blood vessels and raises systemic vascular resistance, helping to improve blood pressure in patients experiencing this type of shock. The use of fluids is critical in managing hypovolemia and ensuring adequate perfusion.

While norepinephrine could also be used and might be considered in some protocols due to its combined alpha and beta agonistic properties, phenylephrine is specifically indicated due to its clear effects on increasing vascular resistance and improving hemodynamics in neurogenic shock, which is characterized by profound vasodilation. The focus on using phenylephrine aligns with established treatment protocols aimed at counteracting the specific pathophysiological changes seen in neurogenic shock.