Key result
A comprehensive review outlines the mechanisms, early recognition, and management of autonomic storms and paroxysmal sympathetic hyperactivity across various neurological disorders in critical care.
Why the study?
Most available literature focuses on autonomic storms after traumatic brain injury, but recognizing and managing autonomic dysfunction across diverse critical care neurological presentations remains challenging.
This review provides a comprehensive overview of the mechanisms and management of autonomic storms in neurocritical care settings.
Alerts clinicians to autonomic storms across neurocritical conditions beyond TBI; leaves standardized management protocols open for prospective validation.
Background: For a favorable outcome, patients admitted to critical care units require continuous monitoring and swift decision-making ability regarding management. One of the biggest challenges in neurocritical care units is the identification and management of autonomic dysfunction and in the worst-case scenario, autonomic storms. Objective: Most of the literature available focuses mainly on autonomic storms following traumatic brain injury. However, due to the myriad neurological presentations in a critical care setting, it is particularly important for physicians and intensivists to suspect and manage autonomic dysfunction in various neurological scenarios. Methods: Understanding the mechanism of paroxysmal sympathetic hyperactivity (PSH) is essential for early recognition and treatment. PSH-AM is an assessment measurement scale to diagnose and assess the severity of PSH in traumatic brain injury. However, this is not yet standardized across all neurological settings. Conclusion: We present a comprehensive report on understanding the mechanism of autonomic storms across various neurological disorders and outline the management.
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Abraham et al. (2022) conducted a review in Autonomic disorders and autonomic storms. A comprehensive review outlines the mechanisms, early recognition, and management of autonomic storms and paroxysmal sympathetic hyperactivity across various neurological disorders in critical care.
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