Acute and Critical Care

Skip Navigation: Skip to contents

SEARCH: Search

Advanced Search

mobile menu button

Search

Page Path: HOME > Search

Review Article

Neurosurgery
The role of catecholamines in aneurysmal subarachnoid hemorrhage: a narrative review: Samantha Nalliah, Tariq Janjua, Luis Rafael Moscote-Salazar, Md Yunus, Amit Agrawal; Acute Crit Care. 2025;40(4):513-520. Published online November 24, 2025; DOI: https://doi.org/10.4266/acc.001525

5,970 View
625 Download
2 Web of Science
2 Crossref

Abstract PDF

The marked release of catecholamines during subarachnoid hemorrhage is an important aspect of the pathobiology following aneurysmal rupture. This narrative review aims to identify how catecholamines influence aneurysmal subarachnoid hemorrhage (aSAH) outcomes. aSAH is a critical neurological condition characterized by hemorrhage into the subarachnoid space, leading to severe neurological deficits and mortality. Catecholamines, including epinephrine, norepinephrine, and dopamine, are the body's stress responses, which can lead to secondary injuries following aSAH. This review was conducted through a targeted literature search of relevant studies examining the relationship between aSAH, catecholamines, and clinical outcomes. Searches were performed in PubMed, Scopus, The Cochrane Library, Medline (Ovid), Embase (Ovid), and CINAHL, including publications up to July 2024. Search terms combined keywords and subject headings related to “subarachnoid hemorrhage” or “aSAH,” “catecholamines,” “epinephrine,” “norepinephrine,” “dopamine,” and outcome-related terms such as “prognosis,” “mortality,” and “neurological outcome.” Articles were selected based on relevance, and key findings were synthesized descriptively to provide a comprehensive overview of current knowledge in this area. Elevated levels of catecholamines are observed following aSAH and are associated with increased sympathetic nervous system activity. This catecholamine surge contributes to pathological processes, including vasospasm, blood-brain barrier disruption, cerebral edema, and neuronal damage. The review highlights the implications of catecholamine levels; where higher concentrations correlate with poorer outcomes and higher mortality rates. Understanding the mechanisms responsible for secondary injury due to catecholamines surge following aSAH shall facilitate the development of therapeutic approaches to prevent secondary brain injury and improve outcomes.

Citations

Citations to this article as recorded by

Associations Between Serum Liver Enzymes and the Rupture Status of Intracranial Aneurysms
Huan Luo, Lu Yu, Jiayuan Zhang, Qishan Chen, Tian Xu, Chao Yu
Journal of Endovascular Therapy.2026;[Epub] CrossRef
Glucose/Potassium Ratio, a Novel Biomarker for the Prognosis of Patients with Subarachnoid Hemorrhage: A Review
Luis E. Fernández-Garza, Valeria A. Fernández-Garza, Daniela Mares-Custodio, Victor Gutiérrez-Ruano, Alexandro Navarrete-Rodríguez, Juan J. Arias-Alzate
Journal of Vascular Diseases.2025; 4(4): 48. CrossRef

Case Report

Cardiology
Catecholamine-Induced Cardiomyopathy associated with Neuroblastoma and Treated with Extracorporeal Membrane Oxygenation as a Bridge to Recovery: Junggu Yi, Si Oh Kim, Jun-mo Park, Sung-hye Byun, Hoon Jung, Seong Wook Hong; Korean J Crit Care Med. 2015;30(4):299-302. Published online November 30, 2015; DOI: https://doi.org/10.4266/kjccm.2015.30.4.299

7,929 View
95 Download
1 Crossref

Abstract PDF

Catecholamine-induced cardiomyopathy associated with neuroblastoma is rarely reported. We report a case of catecholamine-induced cardiomyopathy associated with neuroblastoma in a 33-month-old female that was treated with extracorporeal membrane oxygenation (ECMO). She was tentatively diagnosed with acute myocarditis and presented with hypertension. Because of rapid patient deterioration despite pharmacological treatments, ECMO was applied. ECMO can be helpful in cases of catecholamine-induced cardiomyopathy associated with neuroblastoma.

Citations

Citations to this article as recorded by

COVID-19 and cardiovascular disease: manifestations, pathophysiology, vaccination, and long-term implication
Adel Abdel Moneim, Marwa A. Radwan, Ahmed I. Yousef
Current Medical Research and Opinion.2022; 38(7): 1071. CrossRef

Randomized Controlled Trial

Effects of Alfentanil on Hemodynamic and Catecholamine Responses to Laryngoscopy and Endobronchial Intubation in the Elderly: Kyung Yeon Yoo, Sung Su Chung, Myung Ha Yoon, Seong Wook Jeong, Jeong Il Choi, Chang Young Jeong; Korean J Crit Care Med. 2005;20(2):114-120.

2,287 View
17 Download

Abstract PDF: BACKGROUND
Endobronchial intubation should elicit significant circulatory responses. We examined the effects of alfentanil on hemodynamic and catecholamine responses to endobronchial intubation in elderly patients. METHODS: A total of 60 patients aged over 60 years requiring endobronchial intubation were randomized into three groups of 20 patients each. Anesthesia was induced with thiopental 4~6 mg/kg followed by saline (placebo) or alfentanil 10 or 30microgram/kg given as a bolus over 30 s. Succinylcholine 1 mg/kg was given for neuromuscular block. Laryngoscopy and intubation were performed 1 min later. RESULTS: The intubation significantly increased systolic arterial pressure and heart rate. The maximum pressure changes from pre-intubation values in both alfentanil groups (58+/-27 and 33+/-30 mm Hg in 10 and 30microgram/kg, respectively) were significantly lower compared with that of 83+/-35 mm Hg in the control group. The tachycardiac response was not significantly affected by alfentanil 10microgram/kg, but attenuated by alfentanil 30microgram/kg. The plasma norepinephrine concentrations were increased, which was not affected by alfentanil 10microgram/kg, but was significantly attenuated by alfentanil 30microgram/kg. Both doses of alfentanil abolished the increase of plasma epinephrine concentrations. Three patients in the 30microgram/kg group received ephedrine for hypotension. CONCLUSIONS: This study showed that endobronchial intubation elicited significant pressor response, and that alfentanil 30microgram/kg is more efficacious in attenuating the hemodynamic and catecholamine responses, although potential hypotension warrants a caution of its use, in elderly patients.

First
Prev
Page of 1
Next
Last