Preoperative hypofibrinogenemia is associated with increased intraoperative bleeding in ruptured abdominal aortic aneurysms

Modern Anesthetic Management of Ruptured Abdominal Aortic Aneurysms

“…33 Furthermore, a recent retrospective study showed that SBP <70mmHg was also associated with larger intraoperative blood loss. 34 These studies indicate that systolic blood pressure acts as an important prognostic indicator in patients who present with rAAA.…”

“…A recent retrospective study showed that lower preoperative fibrinogen concentration and platelet count were associated with larger intraoperative blood loss. 34 Specifically, hypofibrinogenemia (<1.5 g/L) was associated with intraoperative blood loss >2L and higher 30-day mortality. 34 Thromboelastography can reliably indicate fibrinolysis, hypercoagulability and / or hypofibrinogenaemia and is used commonly in larger arterial centers to guide criteria is associated with higher overall mortality, the AKIN criteria is a better predictor of mortality in patients who are undergoing AAA surgery.…”

“…34 Specifically, hypofibrinogenemia (<1.5 g/L) was associated with intraoperative blood loss >2L and higher 30-day mortality. 34 Thromboelastography can reliably indicate fibrinolysis, hypercoagulability and / or hypofibrinogenaemia and is used commonly in larger arterial centers to guide criteria is associated with higher overall mortality, the AKIN criteria is a better predictor of mortality in patients who are undergoing AAA surgery. 53 The use of the AKIN criteria for defining acute kidney injury is also advocated by the Vascular Society of Great Britain and Ireland.…”

Anesthetic considerations for endovascular repair of ruptured abdominal aortic aneurysms

“…Massive hemorrhage in patients with rAAA undergoing either open repair or EVAR has been associated with poor outcome, and coagulopathy is an early complication. Disturbance of ibrinogen level, international normalized ratio (INR), prothrombin Time (PT), activated partial thromboplastin time (APTT) and platelets counts are frequently observed [8][9][10]. Therefore, it is prudent for the anesthesia team to activate the "Massive Transfusion Protocol" and obtain universal donor blood products from the blood bank.…”

Hemostasis system in the abdominal aorta aneurysms

“…[14] Разрыв АБА зачастую сопровождается коагулопатией и внутрибрюшным кровотечением. При оценке взаимосвязи основных лабораторных показателей гемостаза (Фг, протромбиновое и активированное частичное тромбопластиновое время, число тромбоцитов) с предоперационными параметрами гемодинамики и интраоперационной кровопотерей оказалось, что низкий дооперационный уровень Фг достоверно коррелировал с гипотензией до и повышенной кровопотерей во время операции по поводу разрыва АБА [18]. У пациентов с гемодинамическим шоком и с артериальным давлением менее 70 мм рт.ст.…”