Intensive care unit management of the trauma patient.
OBJECTIVE
The goal of this concise review is to provide an overview of some of the most important intensive care unit issues and approaches that are unique to trauma patients as compared with the general intensive care unit population.


METHODS
Clinical trials in trauma patients focusing on hemorrhage control, issues in resuscitation, staged operative repair of multiple injuries, the diagnosis and therapy of the abdominal compartment syndrome, and the treatment of traumatic brain injury were identified on PubMed.


CONCLUSIONS
The intensive care unit care of the trauma patient differs from that of other intensive care unit patients in many ways, one of the most important being the need to continuously integrate operative and nonoperative therapy. Although progress in the care of the injured has been made, death due to uncontrolled bleeding, severe head injury, or the development of multiple organ dysfunction syndrome remains all too common in this patient population. Furthermore, due to the potential nature of the injuries, the conundrum not infrequently arises that the optimal treatment for one injury or organ system, such as preoperative permissive hypotension in actively bleeding patients, may result in suboptimal or even deleterious therapy in the presence of another injury, such as traumatic brain injury.


OBJECTIVE
On completion of this article, the reader should be able to:Dr. Deitch has disclosed that he is/was the recipient of grant/research funds from Celgene. Dr. Dayal has disclosed that she has no financial relationships with or interests in any commercial companies pertaining to this educational activity. Lippincott CME Institute, Inc., has identified and resolved all faculty conflicts of interest regarding this educational activity. Visit the Critical Care Medicine Web site (www.ccmjournal.org) for information on obtaining continuing medical education credit.
Deitch
Edwin A
EA
Department of Surgery, New Jersey Medical School-University of Medicine and Dentistry of New Jersey, Newark, USA.
Dayal
Saraswati D
SD
D000005:Abdomen; D002986:Clinical Trials as Topic; D003161:Compartment Syndromes / Q000517:prevention & control; D003422:Critical Care / Q000379:methods*; D006801:Humans; D007362:Intensive Care Units; D009102:Multiple Organ Failure / Q000517:prevention & control; D012151:Resuscitation / Q000379:methods; D012771:Shock, Hemorrhagic / Q000517:prevention & control; D014947:Wounds and Injuries / Q000150:complications / Q000628:therapy*