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Published on: September 19, 2018
Damage control in the management of ruptured abdominal aortic aneurysm: preliminary results
Matthew D Tadlock1, Michael J Sise, Steven T Riccoboni
1Trauma Service, Scripps Mercy Hospital, San Diego, CA, USA.
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.
Conclusion:
DCR use may prove beneficial in the management of rAAA.
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