Resuscitative endovascular balloon occlusion of the aorta (REBOA) in the pre-hospital setting: An additional resuscitation option for uncontrolled catastrophic haemorrhage

Sadek, Samy; Lockey, David; Lendrum, Robbie; Perkins, Zane; Price, Jonathan D.; Davies, Gareth E.

doi:10.1016/j.resuscitation.2016.06.029

Cited by 150 publications

(103 citation statements)

References 20 publications

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“…In fact, it has also been reported that a good outcome was obtained by REBOA in the course of prehospital care for severe pelvic fracture as it can be inserted safely without fluoroscopy [10]. …”

Section: Discussionmentioning

confidence: 99%

Resuscitative endovascular balloon occlusion of the aorta may increase the bleeding of minor thoracic injury in severe multiple trauma patients: a case report

et al. 2017

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BackgroundThe resuscitative endovascular balloon occlusion of the aorta, because of its efficacy and feasibility, has been widely used in treating patients with severe torso trauma. However, complications developing around the site proximal to the occlusion by resuscitative endovascular balloon occlusion of the aorta have almost never been studied.Case presentationA 50-year-old Japanese woman fell from a height of approximately 10 m. At initial arrival, her respiratory rate was 24 breaths/minute, her blood oxygen saturation was 95% under 10 L/minute oxygenation, her pulse rate was 90 beats per minute, and her blood pressure was 180/120 mmHg. Mild lung contusion, hemopneumothorax, unstable pelvic fracture, and retroperitoneal bleeding with extravasation of contrast media were observed in initial computed tomography. As her vital signs had deteriorated during computed tomography, a 7-French aortic occlusion catheter (RESCUE BALLOON®, Tokai Medical Products, Aichi, Japan) was inserted and inflated for aortic occlusion at the first lumbar vertebra level and transcatheter arterial embolization was performed for the pelvic fracture. Her bilateral internal iliac arteries were embolized with a gelatin sponge; however, the embolized sites presented recanalization as coagulopathy appeared. Her bilateral internal iliac arteries were re-embolized by n-butyl-2-cyanoacrylate. The balloon was deflated 18 minutes later. After embolization, repeat computed tomography was performed and a massive hemothorax, which had not been captured on arrival, had appeared in her left pleural cavity. Thoracotomy hemostasis was performed and a hemothorax of approximately 2500 ml was aspirated to search for the source of bleeding. However, clear active bleeding was not captured; resuscitative endovascular balloon occlusion of the aorta may have been the cause of the increased bleeding of the thoracic injury at the proximal site of the aorta occlusion.ConclusionsIt is necessary to note that the use of resuscitative endovascular balloon occlusion of the aorta may increase bleeding in sites proximal to occlusions, even in the case of minor injuries without active bleeding at the initial diagnosis.

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Section: Discussionmentioning

confidence: 99%

Resuscitative endovascular balloon occlusion of the aorta may increase the bleeding of minor thoracic injury in severe multiple trauma patients: a case report

et al. 2017

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“…They are usually related to hemorrhage and could be preventable, which raises the question of deploying REBOA in the pre hospital setting (42,43). Recently, the world's first prehospital REBOA was successfully performed by the London Air Ambulance crew (44). The patient sustained an exsanguinating hemorrhage due to pelvic ring fracture.…”

Section: Outcomes Features and Keys For Successmentioning

confidence: 99%

Resuscitative endovascular balloon occlusion of the aorta (REBOA): What have we learned?

Andrés

Scott²,

Giannoudis

2016

Injury

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“…It aims at occluding the aorta upstream of an abdominal, pelvic or junctional, bleeding site by inflating a small balloon introduced in the femoral artery by retrograde catheterisation. So far, REBOA has been used in trauma centres, but it was used for the first time in prehospitalisation by the London Helicopter Emergency Medical Service (HEMS) (aka London’s air ambulance) in 2016 2. Since then, several civilian and military teams around the world have been working on the interest and the feasibility of installing the device in the field 3…”

Section: Introductionmentioning

confidence: 99%

How many patients could benefit from REBOA in prehospital care? A retrospective study of patients rescued by the doctors of the Paris fire brigade

et al. 2018

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REBOA can be seen as an effective non-surgical solution to ensure complete haemostasis during the prehospital setting. When comparing the high mortality rate following haemorrhage with the REBOA's rare side effects, the risk-benefit balance is positive. Given that 3% of all patients with trauma based on this study would have been eligible for REBOA, we believe that this intervention should be available in the prehospital setting. The results of this study will be used: educational models for REBOA balloon placement using training manikins, with an ultimate aim to undertake a prospective feasibility study in the prehospital setting.

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Resuscitative endovascular balloon occlusion of the aorta (REBOA) in the pre-hospital setting: An additional resuscitation option for uncontrolled catastrophic haemorrhage

Cited by 150 publications

References 20 publications

Resuscitative endovascular balloon occlusion of the aorta may increase the bleeding of minor thoracic injury in severe multiple trauma patients: a case report

Resuscitative endovascular balloon occlusion of the aorta may increase the bleeding of minor thoracic injury in severe multiple trauma patients: a case report

Resuscitative endovascular balloon occlusion of the aorta (REBOA): What have we learned?

How many patients could benefit from REBOA in prehospital care? A retrospective study of patients rescued by the doctors of the Paris fire brigade

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