Department of Vascular Surgery, Academic Medical Centre, Amsterdam, The Netherlands.
Eur J Vasc Endovasc Surg. 2010 Jul;40(1):54-9. doi: 10.1016/j.ejvs.2010.03.022. Epub 2010 Apr 24.
To evaluate a controlled hypotension protocol for patients suspected of a ruptured aneurysm of the abdominal aorta (RAAA) and to identify possible harm to patients with a final diagnosis other than RAAA.
Retrospective analysis of patients suspected of RAAA and transported by Amsterdam ambulance services between January 2006 and October 2007.
Protocol was assessed by reviewing systolic blood pressure (<80 mmHg, 80-100 mmHg or >100 mmHg), administered fluid volume and verbal responsiveness during transport. Patients who could possibly have been harmed by controlled hypotension were identified by final diagnoses.
Fluid administration was according to protocol in 220 of 266 patients analysed for protocol adherence. The remaining patients received too much (21 patients) or too little fluid (25 patients). Data were missing in 29 patients. A RAAA was diagnosed in 81 (27%) of all 295 patients analysed for final diagnosis. Controlled hypotension was achieved in 10% of all patients and in 17% of patients with RAAA. Three patients (1%) with diagnosis other than RAAA were possibly at risk by implementing controlled hypotension.
Protocol was followed in 83% and protocol violations occurred in 17% of patients. The risk of implementing controlled hypotension for all patients suspected of an RAAA by the ambulance staff was low.
评估针对疑似腹主动脉瘤破裂（RAAA）患者的控制性降压方案，并确定对最终诊断非 RAAA 的患者可能造成的伤害。
对 2006 年 1 月至 2007 年 10 月期间由阿姆斯特丹救护车服务转运的疑似 RAAA 患者进行回顾性分析。
通过回顾性分析在转运过程中的收缩压（<80mmHg、80-100mmHg 或>100mmHg）、给予的液体量和语言反应来评估方案。通过最终诊断确定可能因控制性降压而受到伤害的患者。
在 266 例接受方案依从性分析的患者中，有 220 例按方案给予了液体。其余患者接受了过多（21 例）或过少的液体（25 例）。29 例患者的数据缺失。在 295 例接受最终诊断分析的患者中，有 81 例（27%）诊断为 RAAA。在所有患者中，控制性降压的发生率为 10%，在 RAAA 患者中为 17%。3 例（1%）最终诊断非 RAAA 的患者可能因实施控制性降压而处于危险之中。
方案在 83%的患者中得到遵循，在 17%的患者中出现方案违反。由救护车工作人员疑似 RAAA 的所有患者实施控制性降压的风险较低。
