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Berlin A new S3 guideline has been published for the inpatient intensive care of adults with polytrauma. It was developed under the leadership of the German Interdisciplinary Association for Intensive Care and Emergency Medicine (DIVI), with 24 other professional societies involved.

There is an urgent need for recommendations for action for the intensive medical treatment of polytrauma patients following acute care, emphasized the past president of the DIVI, Gernot Marx, Director of the Clinic for Operative Intensive Care Medicine and Intermediate Care at the University Hospital Aachen.

Marx coordinated the guideline together with Frank Hildebrand, Director of the Clinic for Orthopedics, Trauma and Reconstructive Surgery at the University Hospital Aachen.

He stressed that the care of the seriously injured after accidents, but also of war victims from Ukraine, presents the medical teams with ever new challenges. But now, for the first time, we can make validated treatment recommendations that do not end at the door of the intensive care unit, said the trauma surgeon.

However, Hildebrandt continued, when researching the literature it was noticed that there were only shockingly few high-quality study results. There were many publications, but no specific randomized controlled studies that focused exclusively on polytrauma patients. According to both experts, there is a great need for research in the field of intensive care after polytrauma.

Ultimately, the panel of more than 50 experts was able to compile five evidence-based and 48 consensus-based recommendations. Severely injured patients need comprehensive intensive care, especially in the days following the event, emphasized Hildebrand. This is of course very complex. There is a lot to consider and it is important to constantly communicate with the treatment team.

The trauma surgeon cited the treatment of injuries to long bones as an example: If we traumatologists treat fractures of long bones too early, we risk a severe inflammatory reaction that will limit the function of vital organs in the patient. If we wait too long, however, the correct reconstruction of the broken bones is made significantly more difficult. The guideline now shows an evidence-based point in time for this.

The possibilities for external support are also a topic in the guideline. Not every clinic is a maximum care provider. Accordingly, telemedical expertise should definitely be requested, explained Marx. The intensive care centers required for this are currently being set up across Germany.

Based on the results of several studies, it can now be considered proven that telemedical support significantly improves the processes in the intensive care unit, so that it can be assumed with justified optimism that it will also prove to be a valuable aid for trauma patients in the future. © EB/aks/aerzteblatt.de