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Hypotensive Hemostasis in Patients Presenting with Ruptured Aortic Aneurysm

  • Felice Pecoraro
  • Bernard Krüger
  • Johnny Steuer
  • Neal Cayne
  • Zoran Rancic
  • Frank J. Veith
  • Mario LachatEmail author
Chapter
  • 950 Downloads

Abstract

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.

Keywords

Abdominal Aortic Aneurysm Abdominal Compartment Syndrome Endovascular Aneurysm Repair Control Hypotension Maintain Blood Pressure 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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Copyright information

© Springer International Publishing Switzerland 2017

Authors and Affiliations

  • Felice Pecoraro
    • 1
    • 2
  • Bernard Krüger
    • 3
  • Johnny Steuer
    • 1
    • 4
  • Neal Cayne
    • 5
  • Zoran Rancic
    • 1
  • Frank J. Veith
    • 1
    • 5
  • Mario Lachat
    • 1
    Email author
  1. 1.Clinic for Cardiovascular SurgeryUniversity HospitalZurichSwitzerland
  2. 2.Institute for Cardiovascular AnesthesiaUniversity HospitalZurichSwitzerland
  3. 3.Vascular Surgery UnitUniversity of Palermo, University Hospital ‘P. Giaccone’PalermoItaly
  4. 4.Department of Surgery, Section for Vascular SurgerySouth HospitalStockholmSweden
  5. 5.New York University Medical CenterNew YorkUSA

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