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Fast track programs have been introduced in many surgical fields to minimize postoperative morbidity and mortality. Morbidity after elective open infrarenal aneurysm repair is as high as 30%, mortality ranges up to 10%. In terms of open infrarenal aneurysm repair no randomized controlled trials exist to introduce and evaluate such patient care programs.
Prospective randomization of patients admitted with infrarenal aortic aneurysm who undergo elective open repair in a "traditional" and "fast track" treatment arm. Main differences consist in preoperative bowel washout (none vs. 3L cleaning solution) and analgesia (patient controlled analgesia vs. patient controlled epidural analgesia: PCA vs. PCEA). Study endpoints are morbidity and mortality, need for postoperative mechanical ventilation and length of stay (LOS) on intensive care unit (ICU).
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| A | Active Comparator | Traditional management including preoperative bowel washout, patient controlled analgesia (PCA), delayed start of enteral feeding |
|
| B | Experimental | Fast track management including no bowel washout, patient controlled epidural anesthesia, early enteral feeding |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Fast track patient management | Procedure | no bowel washout, patient controlled epidural anesthesia, early enteral feeding |
|
| Measure | Description | Time Frame |
|---|---|---|
| Morbidity and mortality after open infrarenal aortic aneurysm repair | 2 years |
| Measure | Description | Time Frame |
|---|---|---|
| LOS of ICU treatment, need for postoperative mechanical ventilation, day of discharge | 2 years |
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Inclusion Criteria:
Exclusion Criteria:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| University of Ulm | Ulm | 89075 | Germany |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 21343153 | Derived | Muehling BM, Ortlieb L, Oberhuber A, Orend KH. Fast track management reduces the systemic inflammatory response and organ failure following elective infrarenal aortic aneurysm repair. Interact Cardiovasc Thorac Surg. 2011 May;12(5):784-8. doi: 10.1510/icvts.2010.262337. Epub 2011 Feb 22. | |
| 19137363 | Derived |
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| ID | Term |
|---|---|
| D001014 | Aortic Aneurysm |
| ID | Term |
|---|---|
| D000783 | Aneurysm |
| D014652 | Vascular Diseases |
| D002318 | Cardiovascular Diseases |
| D001018 | Aortic Diseases |
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| Traditional management | Procedure | preoperative bowel washout, patient controlled analgesia, delayed start of enteral feeding |
|
| Muehling B, Schelzig H, Steffen P, Meierhenrich R, Sunder-Plassmann L, Orend KH. A prospective randomized trial comparing traditional and fast-track patient care in elective open infrarenal aneurysm repair. World J Surg. 2009 Mar;33(3):577-85. doi: 10.1007/s00268-008-9892-2. |