Difficulties in Retrospectively Characterizing Sepsis in Patients With Trauma

Abstract

The severely injured patient with trauma who is in a catabolic state, combating the lethal triad of death (hypothermia, acidosis, and coagulopathy), has undergone a life-saving damage control operation, is nearing physiological exhaustion, and will be susceptible to infection. The constellation of hemodynamic instability, end-organ failure, and tissue hypoxia are recognizable septic shock symptoms in the patient without trauma; however, when confounded by the posttraumatic setting, the assumption of sepsis and immunologic incompetency must take priority within the clinical differential. The physical examination findings defining the systemic inflammatory response