How do you manage Cerebrogenic tachycardia in you unit?

[salvadorgalvanjr]

Hi guys! I just want to know how you manage in your unit the presence of tachycardia or tachyarrhythmias in patients who had stroke (sub arachnoid hemorrhage) with poor prognosis?

[dianah, ASN]

I don't work in the ICU (used to!), so can't answer your question but I am curious how these situations are handled in your unit?

Just to give a springboard for the topic....

[MunoRN, RN]

In my experience it's highly variable. There's the "don't treat sinus tach" rule, although at some point the Docs will usually give in and decide to treat it directly, but usually the first goal is to treat any underlying conditions contributing to the tachycardia, such as neurogenic fever or overstimulation. Arrhythmia's due to a stroke or other neuro injury aren't unusual, and we usually treat those just like we would in any other patient, although we do tend use calcium channel blockers less in neuro patients for rate control since there is some evidence that they will harm cerebral perfusion more than rate specific beta blockers. If their prognosis is really poor then we'll often coordinate with the transplant center since optimizing organ function for donation may be all we're treating.