Damage control surgery and intensive care

The introduction and establishment of the 'damage control surgery' concept has led to increasing numbers of severely injured and unstable patients being presented to Intensive Care Units (ICU) for ongoing resuscitation. These patients present many challenges for the Intensive Care team and emphasise the need for a multidisciplinary approach to optimise trauma patient management. Multiple issues need to be addressed simultaneously while the overall aim is to rapidly achieve a physiological environment that will allow the best possible recovery. The 'lethal triad' of hypothermia, acidosis, and coagulopathy due to initial hypovolaemia require aggressive correction. From the outset ICU management must also attempt to minimise the complications of these injuries and the resuscitative process. This review will address some of the key issues relating to the care of these patients in the ICU.