Damage control in the management of ruptured abdominal aortic aneurysm: preliminary results.
BACKGROUND
This study compared damage control measures (DCM), including operative techniques (DCO) and resuscitative measures (DCR), with standard treatment (ST) for ruptured abdominal aortic aneurysm (rAAA).


METHODS
Historical cohort study methodology was used to evaluate outcomes for rAAA repairs related to DCM or ST over a 74-month period at a level I trauma center.


RESULTS
Of 28 repairs, 13 (46.4%) were DCM. Compared to ST patients, DCM patients had a lower mean preoperative BP (64.6 vs. 83.2 mm Hg, P = .03) and greater intraoperative blood loss (4.6 vs. 2.1 liters, P = .033). Patients who had both DCR and DCO (DCO & DCR) received more plasma (6.8 vs 2.6 units, P = .039) and less crystalloid (2.8 vs 10.5 liters, P = .005) than those receiving DCO only. A modest decrease in mortality was seen in the DCO & DCR group compared to DCO only. No DCO-related graft infections were observed.


CONCLUSIONS
DCR use may prove beneficial in the management of rAAA.
Tadlock
Matthew D
MD
Trauma Service, Scripps Mercy Hospital, San Diego, CA, USA.
Sise
Michael J
MJ
Riccoboni
Steven T
ST
Sise
C Beth
CB
Sack
Daniel I
DI
Sise
Robert G
RG
Yang
Jack C
JC
Borut
Jeffrey J
JJ
King
Bryan S
BS
D000368:Aged; D000369:Aged, 80 and over; D017544:Aortic Aneurysm, Abdominal / Q000401:mortality / Q000503:physiopathology / Q000601:surgery / Q000628:therapy*; D001019:Aortic Rupture / Q000401:mortality / Q000503:physiopathology / Q000601:surgery / Q000628:therapy*; D016913:Blood Component Transfusion; D016063:Blood Loss, Surgical / Q000517:prevention & control; D001794:Blood Pressure; D016009:Chi-Square Distribution; D000077324:Crystalloid Solutions; D004739:England; D005260:Female; D006801:Humans; D007552:Isotonic Solutions / Q000008:administration & dosage; D008297:Male; D008875:Middle Aged; D010043:Outcome and Process Assessment, Health Care; D010865:Pilot Projects; D012151:Resuscitation / Q000009:adverse effects / Q000401:mortality; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures / Q000009:adverse effects / Q000401:mortality
D000077324:Crystalloid Solutions; D007552:Isotonic Solutions