DOI: https://doi.org/10.22141/2224-0586.3.98.2019.165498

Clinical case of successful treatment of a patient with distal aortic aneurysm rupture and massive blood loss

O.M. Klygunenko, Yu.O. Ploshchenko, S.P. Novikov, O.V. Vasylyshyn, Yu.B. Baida, L.V. Borodai, I.K. Borodina

Abstract


The article presents a clinical case of successful treatment of massive blood loss, which 2 times exceeded the fatal hemorrhage, in surgical intervention for distal abdominal aortic aneurysm rupture. In recent years, in case of massive bleeding, the Damage control resuscitation strategy has become widespread. It consist in the rapid arrest of bleeding surgically, before this — in adherence to the restrictive strategy of volume replacement in order to achieve the target pressure, with systolic one of 80–90 mmHg, which provides a minimum safe level of tissue perfusion, early application of the protocol of massive transfusion with the erythrocytes — plasma — platelets — cryoprecipitate ratio of 1 : 1 : 1 : 1 in effective therapeutic doses (fresh frozen plasma 20 ml/kg, packed red blood cells 15–20 ml/kg), early prophylaxis of coagulopathy with the use of inhibitors of fibrinolysis. The article presents the volume and composition of infusion and transfusion therapy, its effect on hemodynamics, diuresis, water balance and laboratory data. Due to the integrated actions of anesthesiologists of the department, adherence to the Damage control resuscitation, the treatment of the patient was successful.

Keywords


aneurysm; massive blood loss; infusion and transfusion therapy

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