Introduction The diagnosis of death using neurologic criteria is recognized as the complete and irreversible loss of capacity for consciousness and all brain function as a consequence of catastrophic brain injury. Historically and in many countries, this diagnosis is called…
Introduction Pelvic and long bone fractures are found frequently in trauma patients, especially in blunt polytrauma patients with significant injury burden. Initial intensive care management of severe pelvic fractures or long bone injury is similar: damage control resuscitation, hemorrhage control,…
Introduction Trauma is the leading cause of death in patients between 1 and 44 years of age. The trauma patient requires rapid and systematic evaluation by a multidisciplinary team using principles defined by Advanced Trauma Life Support (ATLS). These principles…
Introduction Patients with severe burns today are more likely to survive compared with those injured decades ago. Advances in early source control of deep burns, antimicrobial strategies, and critical care medicine are largely responsible, buoyed by translational research in burn-induced…
Epidemiology A pressure ulcer is any wound that develops in the upper, outer layers of the skin as a result of sustained, external pressure. Pressure ulcers are serious complications among hospitalized patients. They increase healthcare costs, decrease patient quality of…
Atherosclerosis and its thromboembolic complications are leading causes of mortality and morbidity. This progressive disorder usually remains clinically silent until it causes end-organ damage resulting in stroke, ischemic heart disease, and/or peripheral vascular insufficiency. Atherosclerosis characteristically affects the aorta, with…
Introduction Thrombolytic agents comprise a diverse group of compounds that indirectly initiate the lysis of a thrombus. After the initiation of the coagulation cascade, fibrinolytic mechanisms are concomitantly activated to prevent unconstrained thrombosis. Fibrinolysis begins with the cleavage of proenzyme…
Epidemiology Extremity compartment syndrome occurs whenever the tissue pressure within a limited space of the body reaches the point where the circulation, nerve function, and muscle function of that space are compromised. For compartment syndrome to occur, the body compartment…
Historical perspective Pediatric surgeons closing omphaloceles have long recognized the lethal combination of pulmonary compromise and impaired renal function caused by increased intraabdominal pressure (IAP). Silo closure with gradual reduction of abdominal defect was recommended to prevent fulminant organ failure.…
Introduction Mesenteric ischemia is a generic term that implies inadequate blood flow to the intestines. It is relevant from a clinical standpoint as two separate disease processes: acute mesenteric ischemia (AMI) and chronic mesenteric ischemia (CMI). Although the underlying process…