Petrone Patrizio, Pérez-Jiménez Aida, Rodríguez-Perdomo Martín, Brathwaite Collin E M, Joseph D'Andrea K
Am Surg. 2019 Jun 1;85(6):654-662.
Resuscitative endovascular balloon occlusion of the aorta (REBOA) represents an innovative method by which noncompressible bleeding in the torso can be mitigated until definitive treatment can be obtained. To perform a systematic review of the literature on the use of the REBOA in trauma patients. An English and Spanish literature search was performed using MEDLINE, PubMed, and Scopus, from 1948 to 2018. Keywords used were aortic balloon occlusion, resuscitative endovascular balloon, REBOA, hemorrhage, and resuscitative endovascular balloon occlusion of the aorta. The eligilibility criteria included only original and human subject articles. Nontrauma patients, nonbleeding pathology, letters, single case reports, reviews, and pediatric patients were excluded. Two hundred forty-six articles were identified, of which 17 articles were included in this review. The total number of patients was 1340; 69 per cent were men and 31 per cent women. In 465 patients, the aortic zone location was described: 83 per cent the balloon was placed in aortic zone I and 16 per cent in zone III. Systolic blood pressure increased at an average of 52 mmHg before and after aortic occlusion. Although 32 patients (2.4%) presented clinical complications derived from the procedure, no mortality was reported. The trauma-related mortality rate was 58 per cent (776/1340). REBOA is a useful resource for the management of noncompressive torso hemorrhage with promising results in systolic blood pressure and morbidity. Indications for its use include injuries in zones 1 and 3, whereas it is not clear for zone 2 injuries. Additional studies are needed to define the benefits of this procedure.
主动脉复苏性血管内球囊阻断术（REBOA）是一种创新方法，通过该方法可减轻躯干不可压迫性出血，直至获得确定性治疗。对有关REBOA在创伤患者中应用的文献进行系统综述。使用MEDLINE、PubMed和Scopus对1948年至2018年的英文和西班牙文文献进行检索。使用的关键词包括主动脉球囊阻断、复苏性血管内球囊、REBOA、出血和主动脉复苏性血管内球囊阻断术。纳入标准仅包括原创性和人体研究文章。排除非创伤患者、非出血性病变、信函、单病例报告、综述和儿科患者。共识别出246篇文章，其中17篇纳入本综述。患者总数为1340例；男性占69%，女性占31%。在465例患者中描述了主动脉区域位置：83%的球囊置于主动脉I区，16%置于III区。主动脉阻断前后收缩压平均升高52 mmHg。尽管32例患者（2.4%）出现了该操作引起的临床并发症，但未报告死亡病例。创伤相关死亡率为58%（776/1340）。REBOA是治疗非压迫性躯干出血的有用方法，在收缩压和发病率方面有良好结果。其使用指征包括1区和3区损伤，而2区损伤的情况尚不清楚。需要进一步研究来明确该操作的益处。
