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6.7 - Pre- and Post-operative Management of the Critical Care Trauma Patient

from Section 6 - Perioperative Care

Published online by Cambridge University Press:  27 July 2023

By
Rebecca Brinkler  and
Anthony O’Dwyer
Edited by
Ned Gilbert-Kawai ,
Debashish Dutta  and
Carl Waldmann
Ned Gilbert-Kawai
Affiliation:
The Royal Liverpool Hospital
Debashish Dutta
Affiliation:
Princess Alexandra Hospital NHS Trust, Harlow
Carl Waldmann
Affiliation:
Royal Berkshire Hospital, Reading
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Summary

Key Learning Points

  1. 1. Patients are likely to have disturbances of acid–base balance, temperature, coagulation and haemodynamics on arrival.

  2. 2. Damage control surgery may be required to stabilise patients.

  3. 3. Care in the intensive care unit should centre around preventing secondary insult such as sepsis, venous thromboembolism, secondary brain injury and multi-organ failure.

  4. 4. The clinician may need to balance the mean arterial pressure between achieving adequate cerebral perfusion and avoiding further bleeding.

  5. 5. Patients are at significant risk of acute lung injury.

Keywords

traumainjury severitydamage control resuscitation
Type
Chapter
Information
Intensive Care Medicine
The Essential Guide
 , pp. 645 - 647
Publisher: Cambridge University Press
Print publication year: 2021

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References

References and Further Reading

Bota, DP, Melot, C, Ferreira, FL, et al. The Multiple Organ Dysfunction Score (MODS) versus the Sequential Organ Failure Assessment (SOFA) score in outcome prediction. Intensive Care Med 2002;28:1619–24.Google Scholar
Dewar, D, Moore, FA, Moore, EE, Balogh, Z. Postinjury multiple organ failure. Injury 2009;40:912–18.CrossRefGoogle ScholarPubMed
Kushimoto, S, Kudo, D, Kawazoe, Y. Acute traumatic coagulopathy and trauma-induced coagulopathy: an overview. J Intensive Care 2017;5:6.CrossRefGoogle ScholarPubMed
Prout, J, Jones, T, Martin, D. In: Trauma and stabilization. Prout, J, Jones, T, Martin, D (eds). Advanced Training in Anaesthesia. Oxford: Oxford University Press; 2014. pp. 383–99.Google Scholar
Shere-Wolfe, RF, Galvagno, SM Jr, Grissom, TE. Critical care considerations in the management of the trauma patient following initial resuscitation. Scand J Trauma Resusc Emerg Med 2012;20:68.CrossRefGoogle ScholarPubMed

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