ICU protocol may affect the outcome of non-elective abdominal aortic aneurysm repair

摘要: Objectives: to compare the outcome of patients undergoing non-elective abdominal aortic aneurysm repair at two hospitals under care a single vascular surgeon. Design: prospective and retrospective audit 6 years emergency urgent infrarenal surgery. Setting: Lewisham North Southwark Health Authority. Subjects: one hundred forty-five who underwent (46) or (99) an aneurysm. Primary measure: hospital mortality. Secondary measures: acute renal failure, intensive length stay distal ischaemia return theatre. Results: mortality was higher 2 than 1 (28% vs. 9%, p =0.0068). There no significant difference in age, sex, cardiac history, hypertension, diabetes, smoking, impairment (all >0.05). operation time, blood loss base excess end surgery between groups APACHE II scores on admission ICU were similar (median 16 14, >0.03). Pulmonary artery catheters placed 18% compared with 96% 2. Patients received more crystalloid 2990 2300 ml ÷, colloid 4775 1500 ml), inotropes 0) those their first 24 h =0.12) yet incidence failure (30% 6%, p=0.001). survivors longer 3 days, =0.0018) as 17.5 12 =0.0002). Conclusions: both is least good other reported series, but it interesting note that which used less pulmonary intervention (in form inotropes) showed reduced These data may be important assessing different therapeutic strategies employed postoperatively ICU.