Haemodynamic management in ruptured abdominal aortic aneurysm

Ruptured abdominal aortic aneurysm currently accounts for about 1 in 200 deaths and is a critical surgical emergency with an average hospital mortality of 50%. The combination of acute massive haemorrhage in an elderly patient with pre-existing medical disease is highly lethal and a major challenge for any health care system. This article outlines the general principles of management and discusses the problems of haemodynamic assessment and preclamping fluid resuscitation.