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4. New Diagnostic and Therapeutic Approaches for the Care of the Severely Injured Patient.

Author

Hildebrand, Frank, Hildebrand, Frank, and Horst, Klemens

Subjects
Medicine, 3-D navigation, AOSpine classification, Arthroscopy-assisted corrective osteotomy, DHEA, GFAP, IL-10, IL-6, NSE, O-arm radius fracture, PICS, Polytrauma, S100b, SI-screw, TICCS, abbreviated injury scale, acute kidney injury, air ambulance, airway management, augmentation, biomarker, bleeding, burn, carotid artery, catecholamine, cervical artery dissection, chest trauma, complement, complex aortic surgery, computed tomography, distal radius fracture, emergency medicine, exercises, extracorporeal shock wave therapy, flail chest, fragility fracture, fragility fractures, fragility fractures of the pelvis, geriatric fracture, geriatric major trauma, hand, hand function, health service research, hemostasis, hypertrophic scar, immunology, infectious complications, injury severity, injury severity score, insole-force sensors, intraoperative CT scan, intraoperative CT scan in trauma, intubation, knee dislocation, knee joint injuries, laryngoscopy, ligament injuries, living condition, lymphocytes, mTICCS, management of major trauma, massive transfusion, mobility, mortality, multiple trauma, multiple-injured patient, muscle mass, n/a, obesity, outcome, outcome research, overweight, patient-reported outcome, patients, pelvic fracture, pelvic ring, pelvic ring fracture, percutaneous operation, polytrauma, posttraumatic inflammation, prehospital care, prevalence, proliferation, pubic ramus fractures, quality of life, regulatory T cells, rehabilitation, rescue helicopter, ribonuclease, ribonuclease inhibitor 1, risk factors, risk prediction, sacroiliac-screw, sarcopenia, sepsis, severely injured, shock, skeletal mass index, spinal cord injury, spine injury, steroids, thoracic injury, thoracoabdominal aortic aneurysm, tibial plateau malunion, tibial plateau nonunion, time to surgery, transfusion, trauma, trauma resuscitation unit, traumatic brain injury (TBI), venous thrombosis, vertebral artery, video, virtual reality, weight disorders, weight-bearing
Abstract

Summary: Trauma represents a leading cause of death, particularly in the younger population. Traumatic brain injury and hemorrhage are the most common causes of early death, whereas complications such as infections, (multi-)organ failure and "persistent inflammation, immunosuppression, and catabolism syndrome" (PICS) represent relevant factors for late adverse outcomes. Pre- and intra-hospital diagnostic and therapeutic standard operating procedures have been shown to beneficially influence posttraumatic outcome. However, development of patient-specific diagnostic and therapeutic strategies remains challenging due to uncertainties regarding the assessment of the individual risk profile. Furthermore, the relevance of prevention and rehabilitation measures to avoid unfavorable long-term consequences of trauma is not fully elucidated. With this Special Issue, we wanted to reflect the current knowledge about the pathomechanisms associated with the impact of severe injury and its consequences for the further clinical course on the one hand, and to point out new insights in regard to diagnostic and therapeutic approaches on the other hand. Furthermore, interesting aspects for future directions for the care of severely injured patients are illustrated.

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