Operative Procedures in the Intensive Care Unit
Procedures in the intensive care unit (ICU) have traditionally been limited to short procedures that can be performed using only local anesthesia. With the advent of the field of acute care surgery – a blend of trauma, emergency general surgery, and surgical critical care – instances have evolved in which operating in the ICU is not only possible but also necessary. Increased recognition of abdominal compartment syndrome and the use of damage control strategies in both trauma and non-trauma patients have contributed to this change. In general, two types of procedures are performed in the ICU: lifesaving procedures for which a patient is too unstable to attempt transfer to the operating room and uncomplicated procedures for which transfer to the operating room seems unwarranted. Careful organization and preparation with a multidisciplinary team are crucial to ensure patient and clinician safety in both elective and emergent procedures.
KeywordsAcute care surgery Bedside laparotomy Temporary abdominal closure Abdominal compartment syndrome Tracheostomy Percutaneous endoscopic gastrostomy
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