Qasim Zaffer, Brenner Megan, Menaker Jay, Scalea Thomas
Division of Trauma and Surgical Critical Care, R Adams Cowley Shock Trauma Center, University of Maryland School of Medicine, 22 South Greene Street, Baltimore, MD 21201, United States.
Division of Trauma and Surgical Critical Care, R Adams Cowley Shock Trauma Center, University of Maryland School of Medicine, 22 South Greene Street, Baltimore, MD 21201, United States; Division of Vascular Surgery, University of Maryland School of Medicine, 22 South Greene Street, Baltimore, MD 21201, United States.
Resuscitation. 2015 Nov;96:275-9. doi: 10.1016/j.resuscitation.2015.09.003. Epub 2015 Sep 16.
The management of non-compressible torso hemorrhage can be problematic. Current therapy requires either open or interventional radiologic control of bleeding vessels and/or organs. Resuscitative endovascular balloon occlusion of the aorta (REBOA) is a new tool to stabilize patients in shock by achieving temporary inflow occlusion of non-compressible torso hemorrhage. This proactive technique represents a paradigm shift in achieving hemodynamic stability in patients as a bridge to definitive hemostasis. REBOA is applicable by trauma professionals, including emergency physicians, at the bedside in the emergency department, but its use needs to be considered within the context of available evidence and a robust system encompassing training, accreditation, multidisciplinary involvement and quality assurance. We review the evolving role of REBOA and discuss unanswered questions and future applications.
不可压缩性躯干出血的处理可能存在问题。目前的治疗方法需要对出血血管和/或器官进行开放手术或介入放射学控制。复苏性血管内主动脉球囊阻断术（REBOA）是一种新的工具，通过暂时阻断不可压缩性躯干出血的血流来稳定休克患者。这种积极主动的技术代表了在实现患者血流动力学稳定以作为确定性止血桥梁方面的范式转变。REBOA可由包括急诊医生在内的创伤专业人员在急诊科床边应用，但其使用需要在现有证据以及包括培训、认证、多学科参与和质量保证的完善体系背景下加以考虑。我们回顾了REBOA不断演变的作用，并讨论了未解决的问题和未来的应用情况。
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