What is a common treatment for neurogenic shock if initial fluids do not correct hypotension?

Neurogenic shock is a condition characterized by a significant loss of sympathetic tone due to spinal cord injury or other forms of central nervous system disruptions. This leads to vasodilation and resultant hypotension, often accompanied by bradycardia. While initial management typically involves fluid resuscitation to counteract low blood pressure, this may not always be sufficient to restore hemodynamic stability.

In such cases, the use of vasopressors becomes essential. Vasopressors work by causing vasoconstriction, thereby increasing systemic vascular resistance and blood pressure, which is crucial for maintaining adequate perfusion to vital organs. Agents such as norepinephrine or phenylephrine are commonly utilized, as they effectively address the low vascular tone seen in neurogenic shock when fluids alone do not suffice.

Other treatments like antibiotics, corticosteroids, or antihypertensives are not appropriate in this context. Antibiotics are primarily used for infections, corticosteroids may serve various roles in inflammation and spinal cord injury management but are not first-line for acute hypotension, and antihypertensives would further lower blood pressure, worsening the patient's condition. Thus, the use of vasopressors is the most appropriate and effective method to manage persistent hypotension in neuro