Traumatic cardiac arrest

Harris, Tim; Masud, S; Lamond, Anna; Abu-Habsa, Mamoun

doi:10.1097/mej.0000000000000180

Cited by 19 publications

(33 citation statements)

References 0 publications

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“…Resuscitation of patients who sustain a TCA has been associated with a low rate of survival ranging between 0% -35%, depending on the mechanism of injury (2,5). The high survival rate in our study (27%), despite the majority of patients being subjected to blunt trauma, justifies resuscitation efforts with the use of REBOA in patients with TCA.…”

Section: Discussionmentioning

confidence: 60%

“…Traumatic cardiac arrest (TCA) has an extremely high mortality especially in blunt trauma. Cardiopulmonary resuscitation (CPR) after trauma is considered to be of little benefit (2).…”

Section: Introductionmentioning

confidence: 99%

“…However, this does not per se confirm "true" cardiac arrest but may represent a state of inadequate perfusion with impending cardiac arrest. The international resuscitation guidelines (ERC and AHA) advocate a consistent approach to CPR on the basis of up-to-date evidence and expert's consensus opinions about the use of invasive measures, including resuscitative thoracotomy (RT), in order to eliminate reversible causes of cardiac arrest in trauma patients (2)(3)(4)(5). One invasive measure to prevent patients from exsanguination in non-compressible torso hemorrhage, but not yet mentioned in the CPR guidelines, is Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) (6,7).…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Pre-hospital CPR and early REBOA in trauma patients - Results from the ABOTrauma Registry.

Hilbert-Carius

McGreevy

Abu‐Zidan

et al. 2020

Preprint

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Background: Severely injured trauma patients suffering from traumatic cardiac arrest (TCA) and requiring cardiopulmonary resuscitation (CPR) rarely survive. The role of Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) performed early after hospital admission in patients with TCA is not well-defined. As the use of REBOA increases, there is great interest in knowing if there is a survival benefit related to the early use of REBOA after TCA. Using data from the ABOTrauma Registry, we aimed to study the role of REBOA used early after hospital admission in trauma patients who required pre-hospital CPR. Methods: Retrospective and prospective data on the use of REBOA were collected from the ABOTrauma Registry from 11 centers in seven countries globally between 2014 and 2019. In all patients with pre-hospital TCA, the predicted probability of survival, calculated with the Revised Injury Severity Classification II (RISC II), was compared with the observed survival rate. Results: Of 213 patients in the ABOTrauma Registry, 26 patients (12.2%) who had received pre-hospital CPR were identified. The median (range) Injury Severity Score (ISS) was 45.5 (25-75). Fourteen patients (54%) had been admitted to hospital with ongoing CPR. Nine patients (35%) died within the first 24 hours, while seventeen patients (65%) survived post 24 hours. The survival rate to hospital discharge was 27% (n=7). The predicted mortality using the RISC II was 0.977 (25 out of 26). The observed mortality (19 out of 26) was significantly lower than the predicted mortality (p=0.049). Patients not responding to REBOA were more likely to die. Only one (10%) out of 10 non-responders survived. Survival rate in the 16 patients responding to REBOA was 37.5% (n=6). REBOA with a median (range) duration of 45 (8-70) minutes significantly increases blood pressure from median (range) 56.5 (0-147) to 90 (0-200) mmHg. Conclusions: Mortality in patients suffering from TCA and receiving REBOA early after hospital admission is significantly lower than predicted by the RISC II. REBOA may improve survival after TCA. The use of REBOA in these patients should be further investigated. Keywords: REBOA, Cardiac Arrest, Trauma, CPR, Endovascular Resuscitation.

show abstract

Section: Discussionmentioning

confidence: 60%

“…Traumatic cardiac arrest (TCA) has an extremely high mortality especially in blunt trauma. Cardiopulmonary resuscitation (CPR) after trauma is considered to be of little benefit (2).…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Pre-hospital CPR and early REBOA in trauma patients - Results from the ABOTrauma Registry.

Hilbert-Carius

McGreevy

Abu‐Zidan

et al. 2020

Preprint

View full text Add to dashboard Cite

show abstract

“…[3][4][5][6] Factors associated with a favourable outcome are the nature of the injury (penetrating versus blunt trauma), the presence of an organized cardiac rhythm on arrival of the first emergency medical services (EMS), a short CPR duration and a short pre-hospital time. 4,[7][8][9] Helicopter emergency medical services (HEMS) are frequently dispatched to patients in TCA, since they can often deliver specific advanced interventions to address the cause of the arrest that standard ground ambulance crews are unable to provide. Examples of these are thoracostomies to relieve a tension pneumothorax, advanced airway management to relieve an obstructed airway and/ or to improve oxygenation and the transfusion of blood products to treat ongoing blood loss.…”

Section: Q5mentioning

confidence: 99%

“…HEMS are familiar with TCA treatment algorithms 4,9,12,16 and initiate all interventions within their scope of practice as early as possible. likely that the higher than anticipated ROSC rate results from specific interventions addressing underlying treatable causes of TCA that could not be provided by ground ambulance crews before HEMS arrival.…”

Section: Resus 7842 1-7mentioning

confidence: 99%