Stress from a traumatic event results in hyperglycemia. According to Bochicchio et al,1 abdominal surgery patients who were hyperglycemic on postoperative day 1 had an infection rate 2.7 times greater than those who were normoglycemic. Tight glucose control is recommended in critically ill patients. Empiric use of broad-
spectrum antibiotics in trauma patients is not indicated. In a patient who is oxygenating well, intubation is unnecessary. Placement of a drainage catheter is not standard of care in liver lacerations. Intensive care unit admissions are associated with increased morbidity due to the risks of nosocomial infections.
- Maintain serum glucose < 200 mg/dL.
1. Bochicchio GV, Salzano L, Joshi M, et al. Admission preoperative glucose is predictive of morbidity and mortality in trauma patients who require immediate operative intervention. Am Surg 2005;17:171-4.
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