出血控制的新方法：主动脉复苏性血管内球囊阻断术及紧急保存与复苏

Novel Methods for Hemorrhage Control: Resuscitative Endovascular Balloon Occlusion of the Aorta and Emergency Preservation and Resuscitation.

作者信息

Matsushima Kazuhide, Conti Bianca, Chauhan Ravi, Inaba Kenji, Dutton Richard P

机构信息

Division of Acute Care Surgery, LAC+USC Medical Center, 2051 Marengo Street, IPT C5L100, Los Angeles, CA 90033, USA.

Division of Trauma Anesthesiology, R Adams Cowley Shock Trauma Center, University of Maryland School of Medicine, 22 South Greene Street, Baltimore, MD 21201, USA.

出版信息

Anesthesiol Clin. 2019 Mar;37(1):171-182. doi: 10.1016/j.anclin.2018.09.003.

DOI:10.1016/j.anclin.2018.09.003

PMID:30711230

Abstract

Hemorrhage is the leading cause of preventable death after trauma. Junctional and extremity hemorrhage can be temporized with direct pressure and tourniquet application, but noncompressible torso hemorrhage has traditionally required operative or angiographic intervention. Retrograde endovascular balloon occlusion of the aorta (REBOA) can temporize patients with hemorrhage below the diaphragm long enough to enable definitive surgery. REBOA is increasingly available in US trauma centers but prospective, randomized demonstration of efficacy is not yet available. Emergency perfusion and resuscitation is an investigational therapy, limited to use in patients with cardiac arrest due to hemorrhage.

摘要

出血是创伤后可预防死亡的主要原因。交界区和四肢出血可通过直接压迫和使用止血带进行临时处理，但传统上非压迫性躯干出血需要手术或血管造影介入治疗。主动脉逆行血管内球囊阻断术（REBOA）可暂时稳定膈肌以下出血的患者，以便进行确定性手术。在美国创伤中心，REBOA的应用越来越普遍，但尚未有前瞻性、随机对照的疗效证明。紧急灌注和复苏是一种试验性治疗方法，仅限于用于因出血导致心脏骤停的患者。