Trauma and sepsis in the intensive care unit

摘要

Objective. To highlight recent work directing practice standards for the resuscitation and respiratory support of patients sustaining trauma and infection. Material and methods. We undertook a selective review of the literature. Results. Careful use of blood products has received increasing attention in the setting of injury. Early aggressive administration of blood products may reduce the use of transfusion and improve outcomes while overuse of blood products increases the risk of complications, including transfusion-related acute lung injury. The septic patient will also benefit from early administration of fluids, vasoactive drugs and blood products. For sepsis and trauma patients, ventilator strategies favoring reduction of tidal volume and elevation of positive end-expiratory pressure (PEEP) as lung-protective efforts are supported by recent data. Conclusion. Selective use of blood products and fluids leading to a reduction in tidal volume and an increase in PEEP support the enhanced management of trauma and sepsis.