The utility of resuscitative endovascular balloon occlusion of the aorta for temporary hemostasis after extensive bilateral lower extremity injuries: A case report

Shinjo, Takafumi; Izawa, Yoshimitsu; Watanabe, N.; Tominaga, Keiichiro; Yonekawa, Chikara; Lefor, Alan Kawarai; Mato, Takashi

doi:10.1016/j.radcr.2019.03.006

Cited by 2 publications

(1 citation statement)

References 9 publications

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“…Among other benefits, it reduces exsanguination and restores blood pressure in profoundly hypotensive patients [1]. There are several reports of REBOA use for pelvic trauma [2,3] but few studies report outcomes after the initial resuscitation period [4]. The use of REBOA is controversial, however.…”

Section: Introductionmentioning

confidence: 99%

Successfully Stifling Retroperitoneal and Pelvic Exsanguination by Resuscitative Endovascular Balloon Occlusion of the Aorta in a Rural Setting

Bonnici

Davis

2022

JEVTM

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Background: Torso hemorrhages are increasingly controlled by transient employment of Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA). Few studies report patients' conditions after the initial resuscitation period using REBOA, especially in a rural setting. We present a highly successful 1-year post-operative recovery using REBOA for retroperitoneal and pelvic exsanguination. Methods: A 36-year-old female suffered a constellation of traumatic injuries after being ejected from her motorcycle. She arrived at a rural level 1 trauma center shortly thereafter. Results: REBOA was employed to control profuse hemorrhaging and the patient had a highly resilient recovery after one year. A literature review was conducted to highlight the points of contention regarding the controversial use of REBOA. Conclusion: REBOA can produce favorable results with minimal long-term deficits when controlling pelvic exsanguination.

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Section: Introductionmentioning

confidence: 99%

Successfully Stifling Retroperitoneal and Pelvic Exsanguination by Resuscitative Endovascular Balloon Occlusion of the Aorta in a Rural Setting

Bonnici

Davis

2022

JEVTM

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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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The utility of resuscitative endovascular balloon occlusion of the aorta for temporary hemostasis after extensive bilateral lower extremity injuries: A case report

Cited by 2 publications

References 9 publications

Successfully Stifling Retroperitoneal and Pelvic Exsanguination by Resuscitative Endovascular Balloon Occlusion of the Aorta in a Rural Setting

Successfully Stifling Retroperitoneal and Pelvic Exsanguination by Resuscitative Endovascular Balloon Occlusion of the Aorta in a Rural Setting

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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