Department of Anesthesiology and Intensive Care, Rangueil Hospital - University Hospital of Toulouse, 1, avenue du Professeur Jean-Poulhès TSA 50032, 31059 Toulouse cedex 9, France.
Department of Anesthesiology and Intensive Care, Rangueil Hospital - University Hospital of Toulouse, 1, avenue du Professeur Jean-Poulhès TSA 50032, 31059 Toulouse cedex 9, France; EA 4564 - MATN - Laboratoire de Modélisation de l'Agression Tissulaire et de la Nociception, Institut Louis-Bugnard (IFR 150), Toulouse, France.
Anaesth Crit Care Pain Med. 2015 Feb;34(1):53-5. doi: 10.1016/j.accpm.2014.07.002. Epub 2015 Mar 5.
Haemorrhagic shock is commonly encountered in the emergency room and is associated with high morbidity and mortality. For intra-thoracic and intra-abdominal bleeding, treatment usually requires either surgery or an interventional radiologic procedure. Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) has already been described for pelvic fractures and intra-abdominal haemorrhages. In this case report, we present the use of REBOA in a patient admitted for haemorrhagic shock due to a ruptured splenic artery aneurysm.
We describe the case of a 35-year-old male with suspected massive pulmonary embolism. Prior to diagnostic confirmation by CT-scan, the patient suffered several cardiac arrests. CT-scan revealed a massive haemoperitoneum secondary to a ruptured aneurysm of the splenic artery. Because of refractory hypotension despite maximal conventional therapy, we used REBOA before patient transfer to the operating room for splenectomy.
This case underlines the feasibility of REBOA and discusses its role in uncontrollable intra-abdominal haemorrhagic shock.
出血性休克在急诊室中很常见，与高发病率和死亡率相关。对于胸内和腹内出血，治疗通常需要手术或介入放射学程序。复苏性主动脉内球囊阻断（REBOA）已经被描述用于骨盆骨折和腹内出血。在本病例报告中，我们介绍了 REBOA 在因脾动脉瘤破裂导致出血性休克而入院的患者中的应用。
我们描述了一名 35 岁男性的病例，该患者疑似患有大面积肺栓塞。在 CT 扫描确诊之前，患者经历了多次心脏骤停。CT 扫描显示脾动脉瘤破裂导致大量血腹。由于尽管进行了最大的常规治疗，但仍出现难治性低血压，因此在将患者转移到手术室进行脾切除术前，我们使用了 REBOA。
本病例强调了 REBOA 的可行性，并讨论了其在无法控制的腹内出血性休克中的作用。
