Abstract
PurposeResuscitative endovascular balloon occlusion of the aorta (REBOA) is a technique for temporary stabilization of patients with non-compressible torso hemorrhage. This technique has been increasingly used worldwide during the past decade. Despite the good outcomes of translational studies, clinical studies are divided. The aim of this multicenter-international study was to capture REBOA-specific data and outcomes.MethodsREBOA practicing centers were invited to join this online register, which was established in September 2014. REBOA cases were reported, both retrospective and prospective. Demographics, injury patterns, hemodynamic variables, REBOA-specific data, complications and 30-days mortality were reported.ResultsNinety-six cases from 6 different countries were reported between 2011 and 2016. Mean age was 52 ± 22 years and 88% of the cases were blunt trauma with a median injury severity score (ISS) of 41 (IQR 29–50). In the majority of the cases, Zone I REBOA was used. Median systolic blood pressure before balloon inflation was 60 mmHg (IQR 40–80), which increased to 100 mmHg (IQR 80–128) after inflation. Continuous occlusion was applied in 52% of the patients, and 48% received non-continuous occlusion. Occlusion time longer than 60 min was reported as 38 and 14% in the non-continuous and continuous groups, respectively. Complications, such as extremity compartment syndrome (n = 3), were only noted in the continuous occlusion group. The 30-day mortality for non-continuous REBOA was 48%, and 64% for continuous occlusion.ConclusionsThis observational multicenter study presents results regarding continuous and non-continuous REBOA with favorable outcomes. However, further prospective studies are needed to be able to draw conclusions on morbidity and mortality.
Highlights
IntroductionNCTH Non-compressible torso hemorrhage damage control resuscitation (DCR) Damage control resuscitation REBOA Resuscitative endovascular balloon occlusion of the aorta packed red blood cells (PRBC) Packed red blood cells fresh frozen plasma (FFP) Fresh frozen plasma PLT Platelets CPR Cardiopulmonary resuscitation GCS Glasgow coma scale systolic blood pressure (SBP) Systolic blood pressure injury severity score (ISS) Injury severity score ER Emergency room MOF Multiple organ failure mean arterial pressure (MAP) Mean arterial pressure Partial REBOA (pREBOA) Partial resuscitative endovascular balloon occlusion of the aorta iREBOA Intermittent resuscitative endovascular balloon occlusion of the aorta CO Continuous occlusion NCO Non-continuous occlusion
Syndrome (n = 3), were only noted in the continuous occlusion group
3 patients were excluded for having not met the inclusion criteria: Resuscitative endovascular balloon occlusion of the aorta (REBOA) was used in non-traumatic shock (n = 1), the balloon was not deployed due to access difficulties (n = 1), and the balloon was not inflated (n = 1)
Summary
NCTH Non-compressible torso hemorrhage DCR Damage control resuscitation REBOA Resuscitative endovascular balloon occlusion of the aorta PRBC Packed red blood cells FFP Fresh frozen plasma PLT Platelets CPR Cardiopulmonary resuscitation GCS Glasgow coma scale SBP Systolic blood pressure ISS Injury severity score ER Emergency room MOF Multiple organ failure MAP Mean arterial pressure pREBOA Partial resuscitative endovascular balloon occlusion of the aorta iREBOA Intermittent resuscitative endovascular balloon occlusion of the aorta CO Continuous occlusion NCO Non-continuous occlusion. This is controversial, as REBOA delivery requires specialist training, and balloon deflation can be associated with significant ischemia–reperfusion injury. While still in a nascent form, the aim of the current study is to present the initial findings of the registry and patient outcomes
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
