Vasopressor Effect of Indigo Carmine in the Management of Refractory Neurogenic Shock

Neurogenic shock, a dangerous condition arising from spinal cord injuries, can be difficult to treat when it doesn't respond to typical medications like catecholamines. This report discusses a case where a patient's blood pressure was successfully raised using indigo carmine, a dye usually used for other medical purposes. The patient, an elderly woman with a cervical cord injury, underwent surgery, but her blood pressure remained low despite the use of catecholamines. After administering indigo carmine, her blood pressure significantly increased, and her postoperative recovery was smooth. The authors suggest that indigo carmine might have a vasoconstrictive effect, meaning it can narrow blood vessels and raise blood pressure, in patients experiencing neurogenic shock who don't respond to catecholamines. This finding could offer a new approach to managing this challenging condition.

• 1
  Indigo carmine administration resulted in an immediate increase in systolic blood pressure from 60 mmHg to 130 mmHg in a patient with catecholamine-refractory neurogenic shock.
• 2
  The patient's blood pressure stabilized post-indigo carmine administration, allowing for a reduction in the doses of other vasopressors (dobutamine and noradrenaline).
• 3
  The postoperative course was uneventful, and catecholamines were withdrawn on postoperative day 9, suggesting a positive outcome associated with indigo carmine use.