What is the primary goal of managing a ruptured abdominal aortic aneurysm (AAA)?

The primary goal of managing a ruptured abdominal aortic aneurysm (AAA) is to achieve and maintain a mean arterial pressure (MAP) that is adequate to ensure perfusion of vital organs without causing further bleed risk. Aiming for a MAP of 90-100 mmHg is critical as it helps to provide sufficient blood flow to crucial organs while stabilizing the patient in preparation for surgical intervention.

In the context of a ruptured AAA, maintaining adequate blood pressure is essential because it helps counteract hypotension that may occur due to blood loss. The elevated MAP target helps to ensure that perfusion to the heart, brain, and kidneys remains optimal, thereby improving outcomes during surgery and recovery.

Lowering the MAP target to 60-70 mmHg would not provide sufficient perfusion pressure for these vital organs and could lead to further complications. Additionally, controlling pain and managing nausea are important supportive measures, but they are not the primary focus during the acute management of a ruptured AAA. Ensuring the patient does not eat or drink before surgery is a part of preoperative care but does not directly address the critical needs during the immediate management of this emergency.