Impact of resuscitative endovascular balloon occlusion of the aorta (REBOA) in traumatic abdominal and pelvic exsanguination: a systematic review and meta-analysis

Granieri, Stefano; Frassini, Simone; Cimbanassi, Stefania; Bonomi, Alessandro; Paleino, Sissi; Lomaglio, Laura; Chierici, Andrea; Bruno, Federica; Biondi, Raoul; Saverio, Salomone Di; Khan, Mansoor A.; Cotsoglou, Christian

doi:10.1007/s00068-022-01955-6

Cited by 12 publications

(13 citation statements)

References 36 publications

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“…The patient had been consistently unstable for a long time, with manifesting consequences of massive transfusion. Currently, there is still inconclusive evidence whether REBOA reduces the need for blood transfusions, 7 although there are some emerging reports observing reduced transfusion needs 8,9 . We believe there is good reason to consider proactive use of REBOA, 10 to reduce the dose of haemorrhagic shock and the need for massive transfusion with its associated risks 11 …”

Section: Discussionmentioning

confidence: 99%

“…Currently, there is still inconclusive evidence whether REBOA reduces the need for blood transfusions, 7 although there are some emerging reports observing reduced transfusion needs. 8,9 We believe there is good reason to consider proactive use of REBOA, 10 to reduce the dose of haemorrhagic shock and the need for massive transfusion with its associated risks. 11 In this case, an interventional radiologist was needed to place the REBOA.…”

Section: Discussionmentioning

confidence: 99%

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The use of Resuscitative Endovascular Balloon Occlusion of the Aorta in a pregnant woman with a ruptured splenic aneurysm and haemorrhagic shock: A case report

Carlsen

Aalberg

Sandø

et al. 2022

Acta Anaesthesiol Scand

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

The use of Resuscitative Endovascular Balloon Occlusion of the Aorta in a pregnant woman with a ruptured splenic aneurysm and haemorrhagic shock: A case report

Carlsen

Aalberg

Sandø

et al. 2022

Acta Anaesthesiol Scand

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Section: Indications and Utility Of Viscoelastic Testing In The Emerg...mentioning

confidence: 99%

“…However, bleeding can be controlled temporarily in the field with direct pressure, packing, and placement of pelvic binders and tourniquets, as well as in the ED with other advanced maneuvers, including resuscitative endovascular balloon occlusion of the aorta. [33][34][35][36][37] The goal is to transfer the patient to the OR, interventional suite, or hybrid OR for definitive hemorrhage control. [38][39][40][41] Resuscitation strategies for bleeding patients have changed dramatically over the last several decades with an emphasis on early transfusion of balanced ratios of packed red blood cells, plasma, and platelets, or whole blood (where available), and avoidance of crystalloids.…”

Section: Indications and Utility Of Viscoelastic Testing In The Emerg...mentioning

confidence: 99%

Advances in the Management of Coagulopathy in Trauma: The Role of Viscoelastic Hemostatic Assays across All Phases of Trauma Care

Meizoso

Barrett

Moore

et al. 2022

Semin Thromb Hemost

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Uncontrolled bleeding is the leading cause of preventable death following injury. Trauma-induced coagulopathy can manifest as diverse phenotypes ranging from hypocoagulability to hypercoagulability, which can change quickly during the acute phase of trauma care. The major advances in understanding coagulation over the past 25 years have resulted from the cell-based concept, emphasizing the key role of platelets and their interaction with the damaged endothelium. Consequently, conventional plasma-based coagulation testing is not accurate in predicting bleeding and does not provide an assessment of which blood products are indicated. Viscoelastic hemostatic assays (VHA), conducted in whole blood, have emerged as a superior method to guide goal-directed transfusion. The major change in resuscitation has been the shift from unbridled crystalloid loading to judicious balanced blood product administration. Furthermore, the recognition of the rapid changes from hypocoagulability to hypercoagulability has underscored the importance of ongoing surveillance beyond emergent surgery. While the benefits of VHA testing are maximized when used as early as possible, current technology limits use in the pre-hospital setting and the time to results compromises its utility in the emergency department. Thus, most of the reported experience with VHA in trauma is in the operating room and intensive care unit, where there is compelling data to support its value. This overview will address the current and potential role of VHA in the seriously injured patient, throughout the continuum of trauma management.

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“…Other exogenous methods have been used to control bleeding such as Antifibrinolytic agents, eg, Tranexamic acid, Junctional Emergency Treatment Tool™, Combat Ready Clamp, XSTAT ® , ResQFoam, Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA), an invasive technique of aortic occlusion has been reported to be safe and effective in patients with traumatic haemorrhage with hemodynamic instability. 34 The definitive treatment for hypovolaemia should be considered simultaneously. In addition, massive bleeding patient may present with disseminated intravascular coagulation (DIC), resulting in significant coagulation disorders requiring blood and its components for resuscitation.…”

Section: Introductionmentioning

confidence: 99%

Risks in the Management of Polytrauma Patients: Clinical Insights

Iyengar¹,

Venkatesan²,

Jain³

et al. 2023

ORR

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Polytrauma, a patient’s condition with multiple injuries that involve multiple organs or systems, is the leading cause of mortality in young adults. Trauma-related injuries are a major public health concern due to their associated morbidity, high disability, associated death, and socioeconomic consequences. Management of polytrauma patients has evolved over the last few decades due to the development of trauma systems, improved pre-hospital assessment, transport and in-hospital care supported by complementary investigations. Recognising the mortality patterns in trauma has led to significant changes in the approach to managing these patients. A structured approach with application of advanced trauma life support (ATLS) algorithms and optimisation of care based on clinical and physiological parameters has led to the development of early appropriate care (EAC) guidelines to treat these patients, with subsequent improved outcomes in such patients. The journey of a polytrauma patient through the stages of pre-hospital care, emergency resuscitation, in-hospital stabilization and rehabilitation pathway can be associated with risks at any of these phases. We describe the various risks that can be anticipated during the management of polytrauma patients at different stages and provide clinical insights into early recognition and effective treatment of these to improve clinical outcomes.

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Impact of resuscitative endovascular balloon occlusion of the aorta (REBOA) in traumatic abdominal and pelvic exsanguination: a systematic review and meta-analysis

Cited by 12 publications

References 36 publications

The use of Resuscitative Endovascular Balloon Occlusion of the Aorta in a pregnant woman with a ruptured splenic aneurysm and haemorrhagic shock: A case report

The use of Resuscitative Endovascular Balloon Occlusion of the Aorta in a pregnant woman with a ruptured splenic aneurysm and haemorrhagic shock: A case report

Advances in the Management of Coagulopathy in Trauma: The Role of Viscoelastic Hemostatic Assays across All Phases of Trauma Care

Risks in the Management of Polytrauma Patients: Clinical Insights

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