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Prevention of General Complications: Hypothermia, Coagulation Disorders, Infection and Acute Respiratory Distress Syndrome

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The Integrated Approach to Trauma Care

Part of the book series: Update in Intensive Care and Emergency Medicine ((UICM,volume 22))

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Abstract

The most important measures in preventing posttraumatic complications are part of the appropriate initial resuscitation and of the correct priorities of surgical and medical management. Fast restoration of vital organ perfusion, oxygenation, and early surgical intervention is life saving in the early hours, decreases complications for the first weeks, and preserves vital organ function for the rest of life. The most important causes of morbidity and mortality between the second week and the first few months after trauma are (a) vital organ failures such as those of the respiratory system and the kidney and (b) secondary infections, pneumonia and blood stream infection. Frequently there is an interrelation between these two elements. Two other factors are recognized risk factors for both vital organ dysfunction and posttraumatic infection, namely hypothermia and coagulation disorders.

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References

  1. Fried SJ, Bhagwan S, Zeeb P (1986) Normothermic rapid volume replacement for hypovolemic shock: an in vivo study utilizing a new technique. J Trauma 26:183–188

    Article  PubMed  CAS  Google Scholar 

  2. Meyer DM, Hornton JW (1988) Effect of moderate hypothermia in the treatment of canine hemorrhagic shock. Ann Surg 207:462–469

    Article  PubMed  CAS  Google Scholar 

  3. Ream AK, Reitz BA, Silverberg GS (1982) Temperature correction of PCO2 and pH in estimating acid-base status. Anesthesiology 56:41

    Article  PubMed  CAS  Google Scholar 

  4. Keamy MF III, Hall J (1992) Hypothermia (chapter 72). In: Hall JB, Schmidt GA, Wood LD (eds) Principles of critical care. McGraw-Hill, New York, pp 848–857

    Google Scholar 

  5. Greenblatt GM, Ward CF (1986) A new device for rapid fluid administration. Am J Emerg Med 4:197

    Article  PubMed  CAS  Google Scholar 

  6. Schaller MD, Fischer AP, Perret CH (1990) Hyperkalemia. A prognostic factor during acute severe hypothermia. JAMA 264:1842–1845

    Article  PubMed  CAS  Google Scholar 

  7. Auerbach PS (1990) Some people are dead when they’re cold and dead. JAMA 264:1856–1857

    Article  PubMed  CAS  Google Scholar 

  8. Fourrier F, Chopin C, Goudemand J et al (1992) Septic shock, multiple organ failure, and disseminated intravascular coagulation. Chest 101:816–823

    Article  PubMed  CAS  Google Scholar 

  9. Flier JS, Underhill LJ (1992) Molecular and cellular biology of blood coagulation. N Engl J Med 12:800–806

    Article  Google Scholar 

  10. Bickell WH, Wall MJ, Pepe PE et al (1994) Immediate versus delayed fluid resuscitation for hypotensive patients with penetrating torso injuries. N Engl J Med 331:1105–1109

    Article  PubMed  CAS  Google Scholar 

  11. Scherer R, Kox WJ (1993) Consumptive coagulopathies in the critically ill. In: Vincent JL (ed) Yearbook of intensive care and emergency medicine. Springer, Berlin Heidelberg New York, pp 629–637

    Google Scholar 

  12. Blauhut B, Kramar H, Vinazzer M et al (1985) Substitution of antithrombin III in shock and DIC: a randomized study. Thromb Res 39:81–89

    Article  PubMed  CAS  Google Scholar 

  13. Members of the American College of Chest Physicians/Society of Critical Care Medicine Consensus Conference Committee, Bone RC, Balk RA, Cerra FB et al (1992) American College of Chest Physicians/Society of Critical Care Medicine Consensus Conference: definitions for sepsis and organ failure and guidelines for the use of innovative therapies in sepsis. Crit Care Med 20:864–874

    Article  Google Scholar 

  14. Rello J, Torrès A, Ricart M et al (1994) Ventilator-associated pneumonia by Staphylococcus aureus. Comparison of methicillin-resistant and methicillin-sensitive episodes. Am J Respir Crit Care Med 150:1545–1549

    PubMed  CAS  Google Scholar 

  15. Torres A, Serra-Batlles J, Ros E et al (1992) Pulmonary aspiration of gastric contents in patients receiving mechanical ventilation: the effect of body position. Ann Intern Med 116:540–543

    PubMed  CAS  Google Scholar 

  16. Stoutenbeek CP, Van Saene HKF, Miranda DR, Zandstra DF (1984) The effect of selective decontamination of the digestive tract on colonisation and infection rate in multiple trauma patients. Intensive Care Med 10:185–192

    Article  PubMed  CAS  Google Scholar 

  17. Liberati A, Brazzi L, SDD Trialists Group (1993) Selective decontamination of the digestive tract trialists’ collaborative group. Meta-analysis or randomized control trials on the effect of selective decontamination of the digestive tract (SDD). Br Med J 307:525–532

    Article  Google Scholar 

  18. Cook DJ, Fuller HD, Guyatt GH et al for the Canadian Critical Care Trial Groups (1994) Risk factors for gastrointestinal bleeding in critically ill patients. N Engl J Med 330:377–381

    Article  PubMed  CAS  Google Scholar 

  19. Dricks MR, Craven DE, Celli BR et al (1987) Nosocomial pneumonia in intubated patients given sucralfate as compared with antacids or histamine type 2 blockers. N Engl J Med 317:1376–1382

    Article  Google Scholar 

  20. Tryba M (1987) Risk of acute stress bleeding and nosocomial pneumonia in ventilated intensive care unit patients: sucralfate versus antacids. Am J Med 83 [Suppl 3B]: 117–124

    Article  PubMed  CAS  Google Scholar 

  21. Ashbaugh DG, Bigelow DB, Petty TL (1967) Acute respiratory distress in adults. Lancet 11:319–323

    Article  Google Scholar 

  22. Bernard GR, Artigas A, Brigham KL et al, and the consensus committee (1994) The American-European consensus conference on ARDS. Definitions, mechanisms, relevant outcomes, and clinical trial coordination. Am J Respir Crit Care Med 149:818–824

    PubMed  CAS  Google Scholar 

  23. Nuytinck HKS, Offermans XJMW, Kubat K, Goris RJA (1988) Whole-body inflammation in trauma patients. Arch Surg 123:1519–1524

    Article  PubMed  CAS  Google Scholar 

  24. Goris RJA, Te Boekhorst T, Nuytinck J et al (1985) Multiple-organ failure: generalized autodestructive inflammation. Arch Surg 120:1109–1115

    Article  PubMed  CAS  Google Scholar 

  25. Nuytinck JKS, Goris RJA, Redl H, Schlag G, van Munster PJJ (1988) Posttraumatic complications and inflammatory mediators. Arch Surg 121:887–890

    Google Scholar 

  26. Roumen RMH, Hendriks T, Van der Ven-Jongekrijg J et al (1993) Cytokine patterns in patients after major vascular surgery, hemorrhagic shock, and severe blunt trauma. Relation with subsequent adult respiratory distress syndrome and multiple organ failure. Ann Surg 218:769–776

    Article  PubMed  CAS  Google Scholar 

  27. Suter PM, Suter S, Girardin E, Roux-Lombard P, Grau GE, Dayer JM (1992) High bronchoalveolar levels of tumor necrosis factor and its inhibitors, interleukin-1, interferon and elastase in patients with ARDS after trauma, shock or sepsis. Am Rev Respir Dis 145:1016–1022

    Article  PubMed  CAS  Google Scholar 

  28. Montgomery AB, Stager MA, Carrico CJ, Hudson LD (1985) Causes of mortality in patients with the adult respiratory distress syndrome. Am Rev Respir Dis 132:485–489

    PubMed  CAS  Google Scholar 

  29. Dreyfuss D, Soler P, Basset G, Saumon G (1988) High inflation pressure pulmonary edema. Respective effects of high airway pressure, high tidal volume, and positive end-expiratory pressure. Am Rev Respir Dis 137:1159–1164

    PubMed  CAS  Google Scholar 

  30. Parker JC, Townsley MI, Rippe B, Taylor AE, Thigpen J (1984) Increased microvascular permeability in dog lungs due to high peak airway pressures. J Appl Physiol 57:1809–1816

    PubMed  CAS  Google Scholar 

  31. Carlton DP, Cummings JJ, Scheerer RG, Poulain FR, Bland RD (1990) Lung overexpansion increases pulmonary microvascular protein permeability in young lambs. J Appl Physiol 69:577–583

    PubMed  CAS  Google Scholar 

  32. Simmons RS, Berdine GG, Seidenfeld JJ et al (1987) Fluid balance and the adult respiratory distress syndrome. Am Rev Respir Dis 135:924–929

    PubMed  CAS  Google Scholar 

  33. Pepe PE, Hudson LD, Carrico CJ (1984) Early application of positive end-expiratory pressure in patients at risk for adult respiratory distress syndrome. N Engl J Med 311:281–286

    Article  PubMed  CAS  Google Scholar 

  34. Bernard GR, Luce JM, Sprung CL et al (1987) High-dose corticosteroids in patients with the adult respiratory distress syndrome. N Engl J Med 317:1565–1570

    Article  PubMed  CAS  Google Scholar 

  35. Meduri GU, Chinn AJ, Leeper KV et al (1994) Corticosteroid rescue treatment of progressive fibroproliferation in late ARDS. Patterns of response and predictors of outcome. Chest 105:1516–1527

    Article  PubMed  CAS  Google Scholar 

  36. Polk HC Jr, George CD, Wellhausen SR et al (1986) A systematic study of host defense processes in badly injured patients. Ann Surg 204:282–299

    PubMed  Google Scholar 

  37. Stoutenbeek CP, Van Saene HKF, Miranda DR, Zandstra DF, Langrehr D (1987) The effect of oropharyngeal decontamination using topical nonabsorbable antibiotics on the incidence of nosocomial respiratory tract infections in multiple trauma patients. J Trauma 27:357–364

    Article  PubMed  CAS  Google Scholar 

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Authors
  1. P. M. Suter
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Editors and Affiliations

  1. Department of Surgery, University Hospital, University of Nijmegen, Geert Grooteplein 14, NL-6500 HB, Nijmegen, The Netherlands

    Rene Jan Albert Goris

  2. Department of Surgery, University Hospital, University of Zürich, Rämistrasse 100, CH-8091, Zürich, Switzerland

    Otmar Trentz

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© 1995 Springer-Verlag Berlin Heidelberg

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Suter, P.M. (1995). Prevention of General Complications: Hypothermia, Coagulation Disorders, Infection and Acute Respiratory Distress Syndrome. In: Goris, R.J.A., Trentz, O. (eds) The Integrated Approach to Trauma Care. Update in Intensive Care and Emergency Medicine, vol 22. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-79272-4_21

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  • DOI: https://doi.org/10.1007/978-3-642-79272-4_21

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-79274-8

  • Online ISBN: 978-3-642-79272-4

  • eBook Packages: Springer Book Archive

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