Is there a role for REBOA? A system assessment - 20/05/21
, Allen Friend a, David Collins b, Mathew J. Martin c, d, William Long cAbstract |
Introduction |
To analyze our experience to quantify potential need for resuscitative endovascular balloon occlusion of the aorta (REBOA).
Methods |
Retrospective review of patients over a three-year period who presented as a trauma with hemorrhagic shock. Patients were divided into two groups: REBOA Candidate vs. Non-candidates. Injuries, outcomes, and interventions were compared.
Results |
Of 7643 trauma activations, only 37 (0.44%) fit inclusion criteria, of which 16 met criteria for candidacy for potential REBOA placement. The groups did not differ in terms of injury severity, physiology, age, timing of intervention, nor massive transfusion. Survival was linked to TRISS (p = 0.01) and Emergency Room Thoracotomy (p = 0.002). Of Candidates, 8 (50%) had injuries that could have benefited from REBOA, while 7 (44%) had injuries that could be associated with potential harm.
Discussion |
The volume of patients who would potentially benefit from REBOA appears to be small and does not appear to support system wide adoption in the studied region.
Level of evidence |
IV.
Le texte complet de cet article est disponible en PDF.Highlights |
• | In our system, the small number of patients who might benefit from REBOA does not justify the resources needed to maintain expertise. |
• | In our system, pre-existing vascular anomalies are a potential significant risk to performing REBOA. |
• | In our review, REBOA appears to have an equal potential for benefit and harm. |
Keywords : REBOA, Hemorrhagic shock, Trauma, Aortic occlusion
Plan
Vol 221 - N° 6
P. 1233-1237 - juin 2021 Retour au numéro
Article précédent
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