And that's perfectly fine. I prefer to let them f up their own patients without my participation. Btw, trauma surgeons are intensivists; cardiac surgeons (and cardiologists or anesthesiologists) are not, despite trying to play one.
Respectfully, that's why one does a critical care fellowship. What one gains is the perspective, seeing the forest not just the trees, focusing on long-term outcomes and patient benefit, not on knee-jerk rules (every patient on pressors needs a-line and central line) or pleasing the nurses (who have very little competence in judging how a patient should be treated).
In your particular case, a central line was probably indicated. The A-line is always debatable in the ICU, because some patients are pretty stable even on 2 pressors, so one does not need beat to beat BP, not even every 5 minutes. I have had relatively healthy urosepsis patients who I have managed just on high-dose peripheral phenylephrine, no lines. We put in too many lines, and they come with serious risks, especially infectious ones.
As anesthesiologists, we are used to micromanaging our patients, because we abolish so many of their reflexes, and there is ongoing surgical insult and bleeding. In the ICU, we try to keep as many of those reflexes as possible, the patients are not as deep, so there is much less need for micromanagement, unless there is an acute situation. That big picture is what most people playing intensivist, without the proper training, are lacking. As a fellow, when I refused an ICU admission, in most cases it was because I was afraid the patient would get worse in the ICU from a nosocomial infection or from overtreatment. Many healthcare workers, especially nurses and midlevels, have this tendency of thinking that we are better than nature at healing, that getting "good numbers" will translate into better outcomes. Less is sometimes more.
Modern medicine has made us arrogant, and more and more we forget about our major tenet: first do no harm. Just because we can doesn't mean we should. We have to properly understand the particular patient's physiology and situation before we decide that the benefits seriously outweigh the risks. There is no procedure, no medication, no intervention without risk. Even the tylenol knee-jerk nurses give for fever can worsen outcomes. The patient won't necessarily get better just because he looks better on paper.
So, whenever you "resuscitate" an ICU patient in the OR, ask yourself what part of the picture you are missing. Some intensivists just suck, but sometimes it's the anesthesiologist who doesn't know what s/he doesn't know (e.g the kind that puts liters of fluid into the patient and then proudly announces to the surgeon that the patient is off pressors, or the kind that ventilates an already hypoxic patient with 8-10 ml/kg of actual body weight etc.). Respectfully (because you have much more experience than me, if I remember well).
