Coma and haemodynamic instability in the context of trauma

doi:N/A

eISSN: None / ISSN: None

Netharland Journal of Critical Care

2017, Volume 25, Issue 6 : 210-214

Article

Coma and haemodynamic instability in the context of trauma

Gietler A.

Pragt E.

Sels J.W.E.M.

Hannemann P.F.W.

Bouman E.A.

Bergmans D.C.J.J.

Van Mook W.N.K.A.

Abstract

Coma and haemodynamic instability in a trauma patient due to propranolol intoxication. A 51-year-old female was involved in a car accident. Following this event she first became comatose followed by haemodynamic instability (hypotension and later bradycardia). Eventually it proved that these were attributable to a beta-blocker intoxication (propranolol) and not to the trauma. In case of propranolol intoxication (which is highly lipophilic) coma can precede the haemodynamic symptoms. Furthermore, hypotension can precede bradycardia because the negative inotropic effects occur earlier than the negative chronotropic effects. © 2017, Netherlands Society of Intensive Care. All rights reserved.

Keywords

Coma and hemodynamic instability

Propranolol intoxication

Treatment of beta-blocker intoxication

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