The critically ill injured patient.
Patients admitted to the ICU after severe trauma require frequent procedures in the operating room, particularly in cases where a damage control strategy is used. The ventilatory management of these patients in the operating room can be particularly challenging. These patients often have severely impaired respiratory mechanics because of acute lung injury and abdominal compartment syndrome. Consequently, the pressure and flow generation capabilities of standard anesthesia ventilators may be inadequate to support ventilation and gas exchange. This article presents the problems that may be encountered in patients who have severe abdominal and lung injuries, and the current management concepts used in caring for these patients in the critical care setting, to provide guidelines for the anesthetist faced with these patients in the operating room.
Cereda
Maurizio
M
Department of Anesthesiology and Critical Care, University of Pennsylvania, HUP - 781A Dulles, 3400 Spruce Street 4283, Philadelphia, PA 19104, USA.
Weiss
Yoram G
YG
Deutschman
Clifford S
CS
D000818:Animals; D001775:Blood Circulation / Q000502:physiology; D003161:Compartment Syndromes / Q000628:therapy; D003422:Critical Care; D016638:Critical Illness / Q000628:therapy*; D006801:Humans; D020896:Hypovolemia / Q000503:physiopathology / Q000628:therapy; D012121:Respiration, Artificial; D014947:Wounds and Injuries / Q000628:therapy*