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Il paziente politraumatizzato

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Book cover Il monitoraggio delle funzioni vitali nel perioperatorio non cardiochirurgico

Riassunto

La patologia traumatica è assai complessa, difficilmente standardizzabile da un punto di vista clinico, ed è composta da lesioni di modesto rilievo o di gravissimo impatto sulle funzioni vitali. Il monitoraggio dell’effetto e dell’evoluzione di tali traumatismi sugli organi e sui diversi apparati è mandatario per il corretto inquadramento clinico dei pazienti.

La valutazione iniziale del traumatizzato deve seguire il metodo d’intervento suggerito dalle procedure dell’Advanced Trauma Life Support secondo il quale le lesioni traumatiche risultano letali sulla base di schemi temporali riproducibili. L’approccio clinico-diagnostico viene svolto attraverso l’analisi di ciascun distretto interessato dal trauma: cranio, torace, addome (pelvi, rene e vie urinarie, fegato e milza), vasi e midollo. Inoltre nelle fasi sia precoci che tardive, il monitoraggio dell’emorragia e il trattamento della coagulopatia rappresentano uno dei cardini dello standard of care nella patologia traumatica severa.

Durante la degenza in Terapia Intensiva, le complicanze post-traumatiche che possono svilupparsi sono molteplici. Il monitoraggio e il controllo attento di tali complicanze, come l’insorgenza di ipertensione endocranica, ipossia tissutale ecc., portano a un miglioramento dell’outcome.

Il monitoraggio sia in fase precoce che tardiva esercita ormai un ruolo chiave nella gestione dei danni diretti del trauma e delle sue complicanze sia in Pronto Soccorso, che in Sala Operatoria e in Terapia Intensiva. L’applicazione clinica di sistemi di monitoraggio sempre più evoluti ha permesso negli anni un trattamento medico/chirurgico sempre più mirato e sempre meno affetto da complicanze con un notevole impatto sulla sopravvivenza.

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Authors and Affiliations

  1. Servizio di Anestesia, Rianimazione e Terapia Antalgica, Nuovo Ospedale Civile S. Agostino-Estense, Modena

    Marco Rambaldi & Maria Teresa Baranzoni

  2. I° Servizio di Anestesia e Rianimazione, Azienda Ospedaliero-Universitaria Policlinico di Modena, Modena

    Stefano Busani

  3. Cattedra di Anestesia e Rianimazione, Università degli Studi di Modena e Reggio-Emilia, Modena

    Massimo Girardis

Authors
  1. Marco Rambaldi
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  2. Stefano Busani
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  3. Maria Teresa Baranzoni
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  4. Massimo Girardis
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Editors and Affiliations

  1. Dipartimento di Medicina Critica, Istituto Nazionale dei Tumori, Milano

    Biagio Allaria (Past Director, Chief Editor Medical Evidence) (Past Director, Chief Editor Medical Evidence)

  2. Milano

    Biagio Allaria (Past Director, Chief Editor Medical Evidence) (Past Director, Chief Editor Medical Evidence)

  3. UO Rianimazione e Terapia Intensiva, Policlinico San Donato IRCCS San Donato Milanese, Milano

    Marco Dei Poli

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Rambaldi, M., Busani, S., Teresa Baranzoni, M., Girardis, M. (2011). Il paziente politraumatizzato. In: Allaria, B., Dei Poli, M. (eds) Il monitoraggio delle funzioni vitali nel perioperatorio non cardiochirurgico. Springer, Milano. https://doi.org/10.1007/978-88-470-1723-8_13

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  • DOI: https://doi.org/10.1007/978-88-470-1723-8_13

  • Publisher Name: Springer, Milano

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  • Online ISBN: 978-88-470-1723-8

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