6533b833fe1ef96bd129c1fc

RESEARCH PRODUCT

Hypotensive Hemostasis in Patients Presenting with Ruptured Aortic Aneurysm

Felice PecoraroNeal S. CayneMario LachatJohnny SteuerFrank J. VeithZoran RancicBernard Krüger

subject

Abdominal compartment syndromebusiness.industrymedicine.medical_treatmentHypotensive; Hemostasis; Ruptured; Aortic AneurysmHemodynamics030208 emergency & critical care medicineRuptured Aortic Aneurysm030204 cardiovascular system & hematologyHypotensiveHemostasimedicine.diseaseEndovascular aneurysm repairSettore MED/22 - Chirurgia VascolareAbdominal aortic aneurysmRupturedAortic Aneurysm03 medical and health sciences0302 clinical medicineBlood pressureAnesthesiaHemostasiscardiovascular systemmedicinebusinessAortic rupture

description

Hypotensive hemostasis in aortic rupture has been showed to be feasible and advantageous, especially in trauma patients. To date, there are no randomized studies on hypotensive hemostasis in patients with ruptured abdominal aortic aneurysm (rAAA), but observational studies indicate similar advantages when hypotensive hemostasis is used for endovascular aneurysm repair (EVAR) as in trauma patients. Actually, in EVAR for rAAA, a target systolic blood pressure of 90 mmHg or even lower is considered safe in conscious patients. Fluids should be administrated judiciously with the sole aim of maintaining adequate cardiac output and tissue oxygenation, whereas vasoactive pressors or dilatators may be used to adjust systolic blood pressure in hypertension or severe hypotension. Local anesthesia maintains stable hemodynamics and should therefore be employed wherever possible in the treatment of patients presenting with rAAA or blunt aortic injuries.

yearjournalcountryeditionlanguage
2017-01-01
10.1007/978-3-319-23844-9_11http://hdl.handle.net/10447/233909