Human beings, as homeotherms, maintain their temperature within a narrow range around a core temperature of 37° C. Hypothermia can be classified as accidental/spontaneous or induced Classical definition for hypothermia is a body core temperature less than or equal to…
Venous thromboembolism (VTE) is a challenge in the management of injured patients. The mainstay of management requires thoughtful decision making regarding prevention, diagnosis, and appropriate therapy both while hospitalized and post discharge. Concomitant injuries frequently delay initiating VTE prophylaxis or…
Metabolic stress and malnutrition Patients who are injured or undergo extensive and complicated surgery manifest a profound acute phase reaction in response to tissue injury, reperfusion, and hemodynamic disturbances. A metabolic environment of increased catecholamines and cortisol orchestrates an increase…
Key points ■ Fungal infections are a leading cause of nosocomial infections in patients, in particular those residing in the intensive care unit (ICU). ■ Risk factors for developing fungal infections include diabetes mellitus, immunosuppression, previous antibiotic use, prolonged ICU…
Surgeons manage infections that require invasive intervention (e.g., complicated intra-abdominal infections [cIAIs] and skin/soft tissue infections [cSSTIs]), but also surgical patients afflicted by nosocomial infections. Therefore, the surgeon must be concerned with the prevention and treatment of all infections that…
Two broad classes of pneumonia are community-acquired pneumonia (CAP) and nosocomial pneumonia. Nosocomial pneumonia includes patients with hospital-acquired pneumonia (HAP), and ventilator-associated pneumonia (VAP). HAP is defined as pneumonia occurring more than 48 hours after hospital admission that was not…
Infection is the major threat to recovery among most trauma patients that survive the successful resuscitation and intervention of the initial 24 hours following severe injury. The infectious risk may occur from environmental contamination that attended the injury process or…
The immune system is complex, with numerous mechanisms to confront a myriad of both foreign pathogens and even nonforeign neoplasms. The immune response to injury is mediated by the innate and adaptive arms of the immune system. The innate response…
Since the publication of the last edition of Current Therapy in Trauma and Surgical Critical Care , there have been many changes regarding the diagnosis of sepsis, the most accurate definition to capture its true incidence, and its overall burden…
Multiple organ failure (MOF) has plagued surgical intensive care units (ICUs) for nearly 5 decades. MOF was first described as a syndrome of progressive organ failure leading to early death that most often occurred after sepsis (principally from intra-abdominal infections…