Trauma critical care.
The surgical approach to the most injured patients has changed in recent years. Many patients arrive in the intensive care unit with problems that in the past would have been definitively addressed in the operating room, or led to the patient's demise due to continued attempts to complete all surgical procedures, despite deteriorating physiology. As a result, the triad of hypothermia, acidosis, and coagulopathy, along with the frequent complication of abdominal compartment syndrome, are critical factors that require correction in the intensive care unit. Prompt correction is necessary not only to allow expeditious completion of required surgical procedures, but because this triad, unless interrupted, invariably leads to death during resuscitation.
Departments of Surgery and Medicine, and Division of Pulmonary and Critical Care Medicine, Harborview Medical Center, and University of Washington, Seattle, Washington 98104, USA. larrygen@u.washington.edu
L M
LM
Gentilello
D J
DJ
Pierson
D000138:Acidosis / Q000150:complications / Q000628:therapy*; D003161:Compartment Syndromes / Q000150:complications / Q000628:therapy*; D003422:Critical Care; D004211:Disseminated Intravascular Coagulation / Q000150:complications / Q000628:therapy*; D006801:Humans; D007035:Hypothermia / Q000150:complications* / Q000628:therapy*; D014947:Wounds and Injuries / Q000150:complications / Q000628:therapy*