[Post-traumatic dysautonomic crises in intensive care unit: a French national assessment]

Abstract

Introduction: The dysautonomic crises (DC) after traumatic brain injury are an unknown syndrome whereas the first case was described more than 50 years ago. This work aimed to collect their support modalities in French neuro-intensive cares units.

Material and methods: French medical doctors, working in neuro-intensive care unit, were questioned by mail. The questionnaire developed point of prevalence, physiopathology, diagnosis, treatment, prognostic of DC and the existence of a support protocol in the department.

Results: There were 52 replies (40%) of 25 different hospitals. The DC were common or frequent for 77% of intensivists. The large majority (94%) reported a lack of knowledge about the physiopathology of the DC. The DC presented more often a therapeutic problem (28%) than a diagnostic problem (10%). The intensivists didn't know if the DC impacted on the prognostic of the patients (33%). The preferred treatment for the DC was an association of alpha/beta blockers and neuroleptics (38%). The more used preventive treatment was alpha/beta blockers (33%). Only two departments had a support protocol.

Conclusion: Although DC were a common complication in neuro-intensive care unit, their support seems mainly empirical.