Phillips AR, Mikati N, Corbelli N, et al. - As ruptured aortic aneurysms (rAAA) remained linked with extremely high mortality and there are minimal changes in this outcome over the past 20 years, researchers here tested their hypothesis that the volume of preoperative intravenous fluid (IVF) resuscitation in patients with rAAA and preoperative hypotension predicts mortality. They conducted a retrospective study (2001-2019) analyzing the prehospital care of patients with rAAA presenting in transfer to a single institution. Prehospital data were accessible for 307 patients (mean age, 74 ± 10 years, 75% male) out of 537 total rAAA. Air transport was used for the majority of patients (88%, n = 272). Analyses revealed increased risk of mortality from rAAA with any episode of preoperative hypotension. In addition, poor outcomes were observed in correlation with preoperative under- or over-resuscitation outside a 1.0 to 2.5 L window.