Does Practice Match Training? Consultation Practices in Surgical Critical Care.

Introduction: Intensive care unit (ICU) patient and provider attributes may prompt specialty consultation. We sought to determine practice patterns of surgical critical care (SCC) physicians for ICU consultation.

Methods: We surveyed American Association for the Surgery of Trauma members.

Acute Pancreatitis: Exploring Nutrition Implications.

Diseases of the pancreas vary by type, etiology, pathophysiology, and outcomes. One of the principle therapeutic considerations in all types of pancreatic diseases is nutrition. This review will consider acute pancreatitis (AP).

Observing pneumothoraces: The 35-millimeter rule is safe for both blunt and penetrating chest trauma.

Background: As more pneumothoraxes (PTX) are being identified on chest computed tomography (CT), the empiric trigger for tube thoracostomy (TT) versus observation remains unclear. We hypothesized that PTX measuring 35 mm or less on chest CT can be safely observed in both penetrating and blunt trauma mechanisms.

Methods: A retrospective review was conducted of all patients diagnosed with PTX by chest CT between January 2011 and December 2016.

Undetected penetrating bladder injuries presenting as a spontaneously expulsed bullet during voiding: a rare entity and review of the literature.

Background: Patients presenting with a penetrating missile lodged in the pelvis are at risk for having a urinary tract injury. Once in the bladder, the missile can become impacted in the urethra, causing retention that requires extraction. Rarely, the missile can be expulsed spontaneously through the urethra.

Combined rectovesicular injuries from low velocity penetrating trauma in an adult.

The most common concomitant site of injury following a penetrating anorectal injury is the genitourinary tract. In anorectal penetrating injuries, other organ injuries must be thoroughly evaluated. In the presence of concomitant rectal and posterior bladder injury, consideration should be given to omental interposition between the surgically repaired organs to prevent fistula formation.

Enteral nutrition in the critically ill patient.

Timing and route of nutrition provided to critically ill patients can affect their outcome. Early enteral nutrition has been shown to decrease specifically infectious morbidity in the critically ill patient. There is a small group of patients who are malnourished on arrival to the intensive care unit and in these patients parenteral nutrition is beneficial.

A pilot study to explore the safety of perioperative postpyloric enteral nutrition.

Background: The practice of holding enteral nutrition (EN) 8 hours prior to surgery is common. We hypothesized that it was safe to continue postpyloric EN, and we developed an institutional practice pattern to investigate our hypothesis.

Methods: Our pilot study included intubated patients in the surgical intensive care unit at Froedtert Memorial Lutheran Hospital who received EN via a nasojejunal (NJ) feeding tube and underwent 1 or more surgical procedures.

Staged abdominal repairs reduce long-term quality of life.

Introduction: Damage control surgery increasingly requires serial operations and a staged abdominal repair (STAR) for ultimate abdominal closure. The effects of multiple operations on quality of life are unknown. We hypothesized that this population of patients had a lower quality of life than the general U.