REBOA in hemorrhagic shock: a unique non-responder?

Qazi, Alliya; Phillips, Jacquelyn L; Kabutey, Nii-Kabu; Nahmias, Jeffry

doi:10.1136/tsaco-2017-000100

Cited by 2 publications

(2 citation statements)

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“…Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) is a minimally invasive endovascular intervention capable of stopping bleeding and preserving cerebral and cardiac perfusion in the case of hemorrhage from the thorax, abdomen or pelvis [1].…”

Section: Introductionmentioning

confidence: 99%

“…REBOA can be inflated in three aortic zones, based on the site of bleeding: Zone 1, extends from the origin of the left subclavian artery to the celiac artery; Zone 2 extends from the celiac artery to the lowest renal artery; Zone 3 extends from the lowest renal artery to the aortic bifurcation [1]. The use of REBOA has been largely used to manage trauma patients, but it is, nowadays, increasingly being used also for other types of bleeding, such as vascular emergencies, post-partum hemorrhages (PPH), and gastrointestinal and iatrogenic or spontaneous bleeding [2].…”

Section: Introductionmentioning

confidence: 99%

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REBOA: A Device to Gain Time

Lanza,

Angileri,

Fumagalli

et al. 2024

JEVTM

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The management of trauma and emergency procedures (i.e., aneurysm repair, visceral and pelvic bleeding, and others) has undergone considerable changes due to the presence of new endovascular and mini-invasive approaches, which have supplanted the surgical approach in some cases. The use of Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) has been largely used to manage trauma patients, but it is, nowadays, increasingly also being used for other types of bleeding, such as vascular emergencies, post-partum hemorrhages, and gastrointestinal and iatrogenic or spontaneous bleeding. We present a case of an unexpected hemorrhagic shock in a patient with a locally advanced cervix neoplasm involving sacrum and pelvic vessels, where we used a REBOA to manage an intraprocedural massive bleed due to the rupture of the descending branch of the right hypogastric artery.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

REBOA: A Device to Gain Time

Lanza,

Angileri,

Fumagalli

et al. 2024

JEVTM

View full text Add to dashboard Cite

show abstract

Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA): update and insights into current practices and future directions for research and implementation

Thrailkill

Gladin

Thorpe

et al. 2021

Scand J Trauma Resusc Emerg Med

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Background In this review, we assess the state of Resuscitative Endovascular Occlusion of the Aorta (REBOA) today with respect to out-of-hospital (OOH) vs. inhospital (H) use in blunt and penetrating trauma, as well as discuss areas of promising research that may be key in further advancement of REBOA applications. Methods To analyze the trends in REBOA use, we conducted a review of the literature and identified articles with human or animal data that fit the respective inclusion and exclusion criteria. In separate tables, we compiled data extracted from selected articles in categories including injury type, zone and duration of REBOA, setting in which REBOA was performed, sample size, age, sex and outcome. Based on these tables as well as more detailed review of some key cases of REBOA usage, we assessed the current state of REBOA as well as coagulation and histological disturbances associated with its usage. All statistical tests were 2-sided using an alpha=0.05 for significance. Analysis was done using SAS 9.5 (Cary, NC). Tests for significance was done with a t-test for continuous data and a Chi Square Test for categorical data. Results In a total of 44 cases performed outside of a hospital in both military and civilian settings, the overall survival was found to be 88.6%, significantly higher than the 50.4% survival calculated from 1,807 cases of REBOA performed within a hospital (p<.0001). We observe from human data a propensity to use Zone I in penetrating trauma and Zone III in blunt injuries. We observe lower final metabolic markers in animal studies with shorter REBOA time and longer follow-up times. Conclusions Further research related to human use of REBOA must be focused on earlier initiation of REBOA after injury which may depend on development of rapid vascular access devices and techniques more so than on any new improvements in REBOA. Future animal studies should provide detailed multisystem organ assessment to accurately define organ injury and metabolic burden associated with REBOA application. Overall, animal studies must involve realistic models of injury with severe clinical scenarios approximating human trauma and exsanguination, especially with long-term follow-up after injury.

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REBOA in hemorrhagic shock: a unique non-responder?

Cited by 2 publications

References 1 publication

REBOA: A Device to Gain Time

REBOA: A Device to Gain Time

Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA): update and insights into current practices and future directions for research and implementation

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