Conti Bianca M, Richards Justin E, Kundi Rishi, Nascone Jason, Scalea Thomas M, McCunn Maureen
From the *Division of Trauma Anesthesiology, R Adams Cowley Shock Trauma Center; †Division of Vascular Surgery, Department of Surgery; ‡Division of Orthopaedic Traumatology; §R Adams Cowley Shock Trauma Center; and ‖Division of Trauma Anesthesiology, R Adams Cowley Shock Trauma Center, University of Maryland School of Medicine, Baltimore, Maryland.
A A Case Rep. 2017 Sep 1;9(5):154-157. doi: 10.1213/XAA.0000000000000461.
The most common preventable cause of death after trauma is exsanguination due to uncontrolled hemorrhage. Traditionally, anterolateral emergency department thoracotomy is used for temporary control of noncompressible torso hemorrhage and to increase preload after trauma. Resuscitative endovascular balloon occlusion of the aorta is a minimally invasive technique that achieves similar goals. It is therefore imperative for the anesthesiologist to understand physiologic implications during resuscitative endovascular aortic occlusion and after balloon deflation. We report a case of a patient with significant pelvic and lower-extremity trauma who required acute resuscitative endovascular balloon occlusion of the aorta deployment, aggressive resuscitation, and extensive intraoperative hemorrhage control.
创伤后最常见的可预防死亡原因是因出血无法控制导致的失血性休克。传统上,急诊室前外侧开胸术用于临时控制无法压迫的躯干出血,并在创伤后增加前负荷。主动脉内球囊阻断复苏术是一种微创技术,可实现类似目标。因此,麻醉医生必须了解主动脉内球囊阻断复苏术期间及球囊放气后的生理影响。我们报告了一例骨盆和下肢严重创伤患者的病例,该患者需要进行急性主动脉内球囊阻断复苏术、积极复苏以及术中广泛控制出血。