Common PACU problems in trauma patients
Prehospital resuscitation and transportation to an emergency room for further diagnostic assessment and aggressive stabilisation of vital organ functions are cornerstones of the initial management of injured patients. The anaesthetist aims at circulatory stability and sufficient respiratory function. Surgical intervention to stop haemorrhage and to fix long bone fractures are at the top of the priority list for subsequent treatment in the operation room. Trauma patients are then referred to a Postanaesthesia Care Unit (PACU) or an Intensive Care Unit (ICU) depending on the severity of injury and the expected duration of impaired organ function. Tissue injury, hypoxaemia and haemorrhagic shock initiate pathophysiologic, immunologic and metabolic changes that lead to secondary complications. Wudel et al.  studied trauma patients after mass transfusion of more than 20 units and found 28% dying within the first 24 h and another 20% dying later from multiple organ failure. Patients who are specifically prone to complications are defined by advanced age, pretraumatic health condition, shock and the severity of injuries.
KeywordsContinuous Positive Airway Pressure Trauma Patient Functional Residual Capacity Adult Respiratory Distress Syndrome Closing Capacity
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