Noninvasive Hemodynamic Monitoring of Patients Sustaining Severe Penetrating Thoracic, Abdominal and Thoracoabdominal Injuries for Early Recognition and Therapy of Shock

Asensio, Juan A.; Petrone, Patrizio; Wo, C J; Li-Chien, C.; Fathizadeh, Payman; Kimbrell, Brian; García-Núñez, Luis Manuel; Shoemaker, William C.

doi:10.1177/145749690609500304

Cited by 3 publications

(1 citation statement)

References 34 publications

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“…Through the use of invasive (ie, pulmonary artery thermodilution catheters) and noninvasive systems (ie, thoracic electrical bioimpedance devices) for continuous monitoring of cardiac output, William Shoemaker and others have helped to more clearly define the patterns of acute circulatory dysfunction in the early shock phase. Intensive monitoring of those patients with critical illness from high‐risk surgery, trauma, and sepsis linked survival to significantly higher cardiac indices (CIs), oxygen delivery (DO 2 ), and oxygen consumption (VO 2 ) when compared with nonsurvivors with the same comorbidities and type of shock 1 , 2 . Thus, these studies suggest that failure to respond to the hemodynamic dysfunction in the early postinjury phase (ie, ebb phase) portends an unfavorable prognosis, including multisystem organ failure and/or death.…”

Section: Damage Control Surgerymentioning

confidence: 99%

Nutrition and the Open Abdomen

Powell

Collier

2012

Nut in Clin Prac

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Adequate nutrition support is critical in the management of patients with an open abdomen. Despite the literature supporting its use in trauma patients, provider concerns and clinical controversies remain regarding the early administration and long-term sequelae of enteral nutrition (EN) therapy in these patients. The purpose of this article is to review the clinical concepts behind the use of the open abdomen, as well as examine the altered nutrition requirements associated with the maintenance of a temporary laparostomy. The rationale for early EN is described, as well as the pros and cons surrounding the use of supplemental parenteral nutrition in those patients unable to meet nutrition goals enterally in a reasonable time frame. Finally, an open abdomen nutrition support algorithm is provided as part of the critical care plan in these patients who represent the sickest of surgical patients.

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Section: Damage Control Surgerymentioning

confidence: 99%