Gauze Aortic Compression and Super Massive Blood Transfusion Protocol for Injury to the Abdominal Aorta: A Case Report

Abstract

Introduction: Abdominal aorta injury is a rare yet lethal condition, particularly in patients at first-line hospitals, which usually lack in experience with the treatment of major vascular injuries. In this setting, the patient should initially be treated with the intent to prolong survival and enable the consultation of a physician at a tertiary hospital. Case Presentation: This report describes a case, in whom massive blood transfusion and aortic compression with gauze were combined to maintain hemodynamics for approximately one hour successfully. The case was a 40-year-old patient with a penetrating abdominal aorta injury. This patient was admitted to the People’s Hospital of Jingyan County in Leshan, People Republic of China, during May 2017. During the resuscitation process, this patient experienced a blood loss of 12 000 mL (equivalent to 2.5 folds that of a male with a 60-kg body weight) and received an approximate total volume of 9000 mL of transfused blood and blood products. Conclusions: Although supermassive hemorrhages and transfusions approximated to 2.5 times and 2 times, respectively, blood volume of a 60-kg man are extremely rare. This study demonstrates that the simple intervention combined with a massive transfusion with gauze-based aortic compression can effectively prolong the time window, during which an abdominal aorta repair is possible. Therefore, massive transfusion and gauze-based compression are one of the most effective rescue measures to life-threatening hemorrhages.