5Who to CPEX? All planned Open repair Patients ? Open, ? EVAR EVAR according to Red, Amber, Green scoreNot capacity for all EVAR
6CPEX Caseload 53 AAA patients since established 20 proceeded to open 48 planned open/unsure2 TEVAR3 planned EVAR20 proceeded to open12 proceeded to EVARRemaining 21 patients3 Referred to St George’s12 Surgery awaited6 Not to proceed, deceased etc
7Can CPEX help us to fast-track Open AAA patients? 11/20 patients AT > 11 ml/kg/minWhat support was required?
8Outcomes – ITU Support Median discharge day 3 vs 4 Adv. Resp Basic RespAdv. CardiacBasic CardiacRenalAT > 11(ml/kg/min)1511AT < 112391 x Adv Resp pt with AT >11 – 5l intra-op blood loss. ie. No intra-op complications --- No invasive ventilation/inotropesMedian discharge day 3 vs 4
9Future Plans CPEX for all Open AAA patients Vascular Anaesthesia ClinicFor all EVAR pts? Extended recovery/HDU for elective open AAA pts with AT > 11Assuming no complications