Evidence map›Paper›PMID 39230585›Full record

ReviewEuropean journal of trauma and emergency surgery : official publication of the European Trauma Society2024

The non-haemorrhagic vagal response to trauma: a review of hypotensive and bradycardic responses to injury in the absence of bleeding.

Jonathan Woods, Jake Turner, Amy Hughes, Gareth Davies, Gareth Grier

Abstract readReview
In one paragraph

Review in European journal of trauma and emergency surgery : official publication of the European Trauma Society, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Jonathan WoodsBarts and The London School of Medicine and Dentistry, Queen Mary University of London, Mile End Road, London, E1 4NS, England.
Jake TurnerNottingham University Hospitals NHS Trust, Hucknall Road, Nottingham, NG5 1PB, Nottinghamshire, England.
Amy HughesBarts and The London School of Medicine and Dentistry, Queen Mary University of London, Mile End Road, London, E1 4NS, England.
Gareth DaviesEmergency Department, Manx Care, Nobles Hospital, Braddan, IM4 4RJ, Isle of Man.
Gareth GrierBarts and The London School of Medicine and Dentistry, Queen Mary University of London, Mile End Road, London, E1 4NS, England. gareth.grier@nhs.net.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeTrauma has the potential to cause haemorrhage, tissue damage, pain, visceral manipulation and psychological distress. Each of these consequences of trauma can cause changes in autonomic outflow, which dictates a patient's vital signs. Patients who are hypotensive and bradycardic due to a vagally mediated parasympathetic response to pain, psychological distress and visceral manipulation may be confused with those who exhibit bradycardia and hypotension following significant blood volume loss.

methodsThis review summarises literature that describes specific stimuli, patterns of injury and patient characteristics that are associated with a non-haemorrhagic vagal response to trauma.

resultsTwenty-six records described predominantly parasympathetic responses to trauma (both blunt and penetrating) and surgery ("iatrogenic trauma"). Such a non-haemorrhagic vagal response occurs following a wide variety of injury patterns. Patient age and sex are poor predictors of the likelihood of a non-haemorrhagic vagal response. The development and resolution of a non-haemorrhagic vagal response occurs over a heterogenous time period. It is unclear whether speed of onset and resolution is linked to the pattern of injury or other factors causing a predominantly parasympathetic response following non-haemorrhagic trauma.

conclusionThe pattern of injury, patient demographic and speed of onset / resolution associated with the non-haemorrhagic vagal response to trauma may is heterogenous. It is therefore challenging to clinically distinguish between the hypotensive bradycardia due to hypovolaemia secondary to haemorrhage, or a parasympathetic response to trauma in the absence of bleeding.

Indexed as

BradycardiaHypotensionVagus NerveWounds and InjuriesHemorrhageHumansHaemorrhageTraumaVagus nerveVital signs

Identifiers

PMID39230585
PMCPMC11599317

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.