Ruptured abdominal aortic aneurysm: the persistent challenge

Despite improvement in anesthetic and postoperative care, ruptured abdominal aortic aneurysms (AAA) continue to have a high mortality. Thirty-three patients from 1980-1986 underwent surgery at West Virginia University for ruptured AAA, with 12 survivors (36.4 per cent). Age, use of MAST trousers, initial hemoglobin and blood pressure as well as operative time and estimated blood loss were not found to be significantly different between survivors and non-survivors. The blood pressure at the time of induction, during surgery, at the end of surgery, and the final temperature were significantly different. Our results show that the chance of survival is much greater if the patient responds to the initial fluid resuscitation prior to induction, and if blood pressure and temperature are maintained during the operation.