[The vascular surgeon's role in intensive care].
The role of vascular surgeons in the intensive care unit includes two major tasks: (1) consultant activity in complications of different operative specialties, for instance postoperative venous thrombosis after Wertheim's operation, mesenteric superior artery embolus, or arterial injury after total prosthetic replacement of the hip, (2) postoperative care following vascular surgery in order to identify and treat specific complications such as limb ischemia after reconstructive surgery, compartment monitoring after reperfusion injury of the aorta or extremities, carotis monitoring after postoperative apoplexy, and subsumed identification and treatment of ischemic and postischemic states in organs and tissues. Keeping vascular reconstructive options open is particularly important for polytrauma patients with blunt or open vascular injuries beginning from the thoracic aorta ending with subtotal amputation of the lower leg. Vascular surgeons in an intensive care setting play the central role in setting diagnostic course and therapy measures, while organ substitute therapy is within the administrative jurisdiction of the intensivist. Considering the complexity of morbidity in vascular patients, consultation by the intensivist, cardiologist, and neurologist is warranted.
Schelzig
H
H
Universitätsklinik für Thorax- und Gefässchirurgie, Universität Ulm, Steinhövelstrasse 9, 89075 Ulm. hubert.schelzig@medizin.uni-ulm.de
Orend
K H
KH
Sunder-Plassmann
L
L
D003422:Critical Care; D006801:Humans; D010348:Patient Care Team; D011182:Postoperative Care; D011183:Postoperative Complications / Q000175:diagnosis / Q000628:therapy*; D012017:Referral and Consultation; D014656:Vascular Surgical Procedures