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Research Article| Volume 2, ISSUE 4, P839-852, October 1986

Critical Care Complications in the Trauma Patient

  • Laurie Langdale
    Affiliations
    Fellow in Critical Care Medicine, University of California, San Francisco, School of Medicine, San Francisco, California
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  • William P. Schecter
    Correspondence
    Corresponding author: Intensive Care Unit, San Francisco General Hospital, 1001 Potrero Avenue, San Francisco, CA 94110
    Affiliations
    Assistant Clinical Professor of Surgery, University of California, San Francisco, School of Medicine, San Francisco, California

    Associate Director, San Francisco General Hospital, San Francisco, California
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      This paper is only available as a PDF. To read, Please Download here.
      Critical care therapy of the multiply injured patient results in multiple potential complications. Nosocomial infections, gastrointestinal complications, and pulmonary complications are reviewed. Complications that are anticipated can often be avoided by prophylactic therapy. Early intervention, once complications have occurred, may result in decreased morbidity and mortality.
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      References

        • Ashbaugh P.G.
        • Petty L.L.
        • Bigelow D.B.
        • et al.
        Continuous positive pressure breathing (CPPB) in adult respiratory distress syndrome.
        J. Thorac. Cardiovasc. Surg. 1969; 57: 31
        • Barlow B.
        • Gandhi R.
        Renal artery thrombosis following blunt trauma.
        J. Trauma. 1980; 20: 614
        • Brue A.E.
        • Chaundry I.H.
        Prevention of multiple system failure.
        Surg. Clin. North Am. 1980; 60: 1167
        • Baumgaertner J.D.
        • Burgo-Black A.L.
        • Pyntiah N.
        • et al.
        Severe cytomegalovirus infection in multiple transfused, splenectomized trauma patients.
        Lancet. 1982; 2: 63
        • Berk J.L.
        • Sampliner J.E.
        Handbook of Critical Care.
        Little, Brown and Co., Boston1982
        • Bill R.C.
        • Coalson J.J.
        • Smith J.D.
        • et al.
        Multiple organ system failure and infection in adult respiratory distress syndrome.
        Ann. Intern. Med. 1983; 99: 293
        • Bivens B.A.
        • Sachatello C.R.
        • Daugherty M.E.
        • et al.
        Diagnostic peritoneal lavage is superior to clinical evaluation in blunt abdominal trauma.
        Am. Surg. 1978; 44: 637
        • Blaisdell F.W.
        • Trunkey D.D.
        Trauma Management. Volume 1. Abdominal Trauma.
        Thieme-Stratton, New York1982
        • Borzotta A.P.
        • Polk H.C.
        Multiple system organ failure.
        Surg. Clin. North Am. 1983; 63: 315
        • Brigham K.L.
        • Bowers R.E.
        • McKeen C.R.
        Methylprednisolone prevention of increased lung vascular permeability following endotoxemia in sheep.
        J. Clin. Invest. 1981; 67: 1103
        • Caplan E.S.
        • Hoyt N.
        • Cowley R.A.
        Changing patterns of nosocomial infections in severely traumatized patients.
        Am. Surg. 1979; 45: 204
        • Cinetta J.M.
        • Augenstein J.S.
        Acute respiratory failure following surgery and trauma.
        in: Greenfield L.J. Complications in Surgery and Trauma. J.B. Lippincott Co., Philadelphia1982: 243
        • Diamond J.R.
        • Yoburn D.C.
        Non-oliguric acute renal failure.
        Arch. Intern. Med. 1982; 142: 1882
        • Dillinger E.P.
        • Oreskovich M.R.
        • Wertz M.J.
        • et al.
        Risk of infection following laparotomy for penetrating abdominal injury.
        Arch. Surg. 1984; 119: 20
        • Drapanas T.
        • Woolverton W.C.
        • Reeder J.W.
        • et al.
        Experiences with surgical management of acute gastric mucosal hemorrhage.
        Ann. Surg. 1971; 173: 628
        • Fein A.M.
        • Lippmann M.
        • Holtzman H.
        • et al.
        The risk factors, incidence, and prognosis of ARDS following septicemia.
        Chest. 1983; 53: 40
        • Fry D.E.
        • Garrison R.N.
        • Heitsch R.C.
        • et al.
        Determinants of death in patients with intra-abdominal abscess.
        Surgery. 1980; 88: 517
        • Gagic N.
        • Frey C.F.
        The results of cholecystostomy for the treatment of acute cholecystitis.
        Surg. Gynecol. Obstet. 1975; 140: 255
        • Gingrich R.A.
        • Awe W.C.
        • Boyden A.M.
        • et al.
        Cholecystostomy in acute cholecystitis.
        Am. J. Surg. 1968; 116: 310
        • Goris R.J.A.
        • Draaisma J.
        Causes of death after blunt trauma.
        J. Trauma. 1982; 22: 141
      1. Greenwalt, T.J.: General principles of blood transfusion. AMA, 1977.

        • Grieco J.G.
        • Perry J.F.
        Retroperitoneal hematoma following blunt trauma: Its clinical importance.
        J. Trauma. 1980; 20: 733
        • Griffith G.L.
        • Morell K.I.
        • Coleman K.
        • et al.
        Acute reversible intrinsic renal failure.
        Surg. Gynecol. Obstet. 1978; 146: 631
        • Gump F.E.
        Trauma and hemorrhage.
        Surg. Clin. North Am. 1983; 63: 305
        • Halloran L.G.
        • Zfass A.M.
        • Gayle W.E.
        • et al.
        Prevention of acute gastrointestinal complications after severe head injury: A controlled trial of cimetidine prophylaxis..
        Am. J. Surg. 1980; 139: 44
        • Hardy J.D.
        • Blalock J.B.
        High-output gastrointestinal fistula.
        in: Hardy J.D. Critical Surgical Illness. W.B. Saunders Co., Philadelphia1980: 478
        • Hastings P.R.
        • Skillman J.J.
        • Bushnell L.S.
        • et al.
        Antacid titration in the prevention of acute gastrointestinal bleeding.
        N. Engl. J. Med. 1978; 298: 1041
        • Hopewell P.C.
        • Murray J.F.
        The adult respiratory distress syndrome.
        Annu. Rev. Med. 1976; 27: 343
        • Hudson L.D.
        Causes of ARDS: Clinical recognition.
        Clin. Chest Med. 1982; 3: 195-212
        • Long T.N.
        • Heinbach D.M.
        • Carrico C.J.
        Acalculous cholecystitis in critically ill patients.
        Am. J. Surg. 1978; 136: 31
        • Lucas C.E.
        Renal considerations in the injured patient.
        Surg. Clin. North Am. 1982; 62: 133
        • Lucas C.E.
        • Sugawa C.
        • Friend W.
        • et al.
        Therapeutic implications of disturbed gastric physiology in patients with stress ulcerations.
        Am. J. Surg. 1972; 123: 125-134
        • Martin L.F.
        • Max M.H.
        • Polk Jr., B.C.
        Failure of gastric pH control in the critically ill: A valid sign of sepsis.
        Surgery. 1980; 88: 69
        • Mayhall C.G.
        Complications of antibiotic administration.
        in: Greenfield L.J. Complications in Surgery and Trauma. J.B. Lippincott Co., Philadelphia1984: 193
        • McMurray S.B.
        • Luft F.C.
        • Maxwell D.R.
        • et al.
        Prevailing patterns and predictor variables in patients with acute tubular necrosis.
        Arch. Intern. Med. 1978; 138: 950
        • Miller T.R.
        • Anderson R.J.
        • Linas S.L.
        • et al.
        Urinary diagnostic indices in acute renal failure: A prospective study.
        Ann. Intern. Med. 1978; 89: 47
        • Norton L.
        • Greer J.
        • Eiseman B.
        Gastric secretory response to head injury.
        Arch. Surg. 1970; 101: 200
        • O’Connor N.E.
        • Moore F.B.
        Post-traumatic pulmonary insufficiency: Acute respiratory failure in adult surgical patients.
        in: Hardy J.D. Critical Surgical Illness. W.B. Saunders Co., Philadelphia1980: 1
        • Oken D.E.
        On the differential diagnosis of acute renal failure.
        Am. J. Med. 1981; 71: 916
        • Pepe P.E.
        • Potkin R.T.
        • Reus D.H.
        • et al.
        Clinical predictors of the adult respiratory distress syndrome.
        Am. J. Surg. 1982; 144: 124
        • Peterson S.R.
        • Sheldon G.F.
        Acute acalculous cholecystitis: A complication of hyperalimentation.
        Am. J. Surg. 1979; 138: 814
        • Petro A.B.
        Postoperative oliguria, blood and electrolyte disequilibrium and acid base imbalance.
        in: Hardy J.D. Critical Surgical Illness. W.B. Saunders Co., Philadelphia1980: 46
        • Pinilla J.C.
        Acute respiratory failure in severe blunt chest trauma.
        J. Trauma. 1984; 22: 221
        • Prewitt R.M.
        • McCarthy J.
        • Wood L.D.H.
        Treatment of acute low pressure pulmonary edema in dogs. Relative effects of hydrostatic and oncotic pressure, nitroprusside and positive end-expiratory pressure.
        J. Clin. Invest. 1981; 67: 409
        • Riska E.B.
        • Myllynen P.
        Fat embolism in patients with multiple injuries.
        J. Trauma. 1982; 22: 891
        • Ron D.
        • Taitelman U.
        • Michaelson M.
        • et al.
        Prevention of acute renal failure in traumatic rhabdomyolysis.
        Arch. Intern. Med. 1984; 144: 277
        • Root H.D.
        • Ileizer R.I.
        • Perry Jr., J.F.
        The clinical and experimental aspects of peritoneal response to injury.
        Arch. Surg. 1967; 95: 531
        • Sharp D.E.
        Complications of blood and blood product transfusion.
        in: Greenfield L.J. Complications in Surgery and Trauma. J.B. Lippincott, Co., Philadelphia1984: 148
        • Shin B.
        • Mackenzie C.F.
        • Cowley R.A.
        Changing patterns of post-traumatic acute renal failure.
        Am. Surg. 1979; 45: 182
        • Shires G.T.
        • Dineen P.
        Sepsis following burns: Trauma and abdominal infections.
        Arch. Intern. Med. 1982; 142: 2012
        • Shuman W.P.
        • Rogers J.V.
        • Rudd T.G.
        • et al.
        Low sensitivity of sonography end cholescintigraphy in acalculous cholecystitis.
        Am. J. Roentgenol. 1984; 145: 531
        • Snyder S.K.
        • Hahn H.H.
        Diagnosis and treatment of intraabdominal abscess in critically ill patients.
        Surg. Clin. North Am. 1982; 62: 229
        • Stothert Jr., J.C.
        • Simonowitz D.A.
        • Dellinger E.P.
        • et al.
        Randomized, prospective evaluation of cimetidine and antacid control of gastric pH in the critically ill.
        Ann. Surg. 1980; 192: 169
        • Strain J.
        • Moore E.E.
        • Markorchick V.J.
        • et al.
        Cimetidine for the prophylaxis of potential gastric acid aspiration pneumonitis in trauma patients.
        J. Trauma. 1981; 21: 49
        • Sturm J.A.
        • Carpenter M.A.
        • Lewis F.R.
        Water and protein movement in the sheep lung after septic shock: Effects of colloid versus crystalloid resuscitation.
        J. Surg. Res. 1979; 26: 233-248
        • Thai E.R.
        Peritoneal lavage—reliability of RBC count in patients with stab wounds to the chest.
        Arch. Surg. 1984; 119: 579
        • Tilney N.L.
        • Lazarus J.M.
        Acute renal failure in surgical patients.
        Surg. Clin. North Am. 1983; 63: 357
        • Tilney N.L.
        • Bailey G.L.
        • Morgan A.P.
        Sequential system failure after rupture of abdominal aortic aneurysms.
        Ann. Surg. 1973; 178: 117
        • Tranbaugh R.F.
        • Lewis F.R.
        Respiratory insufficiency.
        Surg. Clin. North. Am. 1982; 62: 121
        • Tranbaugh R.F.
        • Elings V.B.
        • Christensen J.
        • et al.
        Determinants of pulmonary interstitial fluid accumulations after trauma.
        J. Trauma. 1982; 22: 820
        • Virgilio R.W.
        • Rice C.L.
        • Smith D.E.
        • et al.
        Crystalloid vs. colloid resuscitation: Is one better?.
        Surgery. 1979; 85: 129-139
        • Whiley N.O.
        • Shatney C.H.
        Diagnosis of abdominal abscess in patients with major trauma: The use of computed tomography.
        Radiology. 1983; 147: 179
        • White G.L.
        • Archer L.T.
        • Beller B.K.
        • et al.
        Increased survival with methylprednisone treatment in canine endotoxin shock.
        J. Surg. Res. 1978; 25: 357