Surgical intensive care unit—the trauma surgery perspective

Abstract

Furthermore, the fundamental knowledge of the injury severity, understanding of the trauma mechanism, surgical treatment strategies and specific techniques of surgical intensive care are pointed out as essentials for a successful intensive care therapy.

Undiagnosed medical comorbidities in the uninsured

“…Early aggressive management has seen dramatic improvements in intensive care unit (ICU) care during the past decade, including tight glucose control, A-blocker use, and heart rate control, and low tidal volume ventilator management. 9,10 Furthermore, when compared with patients with well-managed comorbidities, poorly controlled comorbidities affect otherwise unrelated surgical illness, including being associated with higher morbidity and mortality. 11Y14 We believe that discrepancies seen in trauma outcomes associated with nonmedical factors such as insurance, race, and socioeconomic status may in fact be caused by undiagnosed and thereby untreated comorbidities before the traumatic event.…”

The specialty of surgical critical care: A white paper from the American Association for the Surgery of Trauma Critical Care Committee

“…Among complex surgical and trauma patients, surgeons are uniquely trained to recognize and manage such nuanced resuscitation and injury-specific sequelae including rhabdomyolysis, missed traumatic injuries, transfusion-associated acute lung injury, and sequelae of closed head injury. Early diagnosis and intervention for these issues are necessary to avoid adverse outcomes 41 . Similarly, timing of source control for intra-abdominal infections is important to reduce morbidity and mortality in critically ill patients 42 .…”

“…Early diagnosis and intervention for these issues are necessary to avoid adverse outcomes. 41 Similarly, timing of source control for intra-abdominal infections is important to reduce morbidity and mortality in critically ill patients. 42 For example, mesenteric ischemia may manifest as an occult source of sepsis in patients admitted to an ICU, or occur secondarily as a result of a pro-thrombotic state related to the primary critical illness, as was seen in patients with COVID-19 infection.…”

Overall Distribution of Trauma‐Related Deaths in Berlin 2010: The Weakest Links of the Chain of Survival are Emergency Medicine and Critical Care: Reply

“…The results of our second study will clarify that the quality of preclinical trauma management is overestimated, and therefore the significance and potential to reduce traumatic deaths is not recognized. With the primary focus on advancements in critical care, one of the two ''hot spots'' of trauma management, the main problem, preclinical trauma management, is disregarded [2]. In a recent study, we revealed the need for individualized preclinical treatment of trauma patients with invasive preclinical measures, e.g., intubation and chest tubing [3].…”