Department of Cardiothoracic and Vascular Surgery, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
Department of Surgery, College of Medicine and Health Science, UAE University, Al-Ain, United Arab Emirates.
Shock. 2020 Aug;54(2):218-223. doi: 10.1097/SHK.0000000000001500.
Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) may improve Systolic Blood Pressure (SBP) in hypovolemic shock. It has, however, not been studied in patients with impending traumatic cardiac arrest (ITCA). We aimed to study the feasibility and clinical outcome of REBOA in patients with ITCA using data from the ABOTrauma Registry.
Retrospective and prospective data on the use of REBOA from 16 centers globally were collected. SBP was measured both at pre- and post-REBOA inflation. Data collected included patients' demography, vascular access technique, number of attempts, catheter size, operator, zone and duration of occlusion, and clinical outcome.
There were 74 patients in this high-risk patient group. REBOA was performed on all patients. A 7-10Fr catheter was used in 66.7% and 58.5% were placed on the first attempt, 52.1% through blind insertion and 93.2% inflated in Zone I, 64.8% for a period of 30 to 60 min, 82.1% by ER doctors, trauma surgeons, or vascular surgeons. SBP significantly improved to 90 mm Hg following the inflation of REBOA. 36.6% of the patients survived.
Our study has shown that REBOA may be performed in patients with ITCA, SBP can be elevated, and 36.6% of the patients survived if REBOA placement is successful.
主动脉球囊阻断复苏术(REBOA)可能会提高失血性休克患者的收缩压(SBP)。然而,它尚未在即将发生创伤性心脏骤停(ITCA)的患者中进行研究。我们旨在使用 ABOTrauma 登记处的数据研究 REBOA 在 ITCA 患者中的可行性和临床结局。
从全球 16 个中心收集了关于使用 REBOA 的回顾性和前瞻性数据。在充气前后测量 SBP。收集的数据包括患者的人口统计学、血管通路技术、尝试次数、导管大小、操作者、闭塞区域和时间以及临床结局。
该高危患者组有 74 例患者。所有患者均进行了 REBOA。66.7%使用 7-10Fr 导管,58.5%首次尝试放置成功,52.1%通过盲目插入,93.2%在 I 区充气,64.8%充气时间为 30-60 分钟,82.1%由急诊医生、创伤外科医生或血管外科医生进行。REBOA 充气后 SBP 显著升高至 90mmHg。36.6%的患者存活。
我们的研究表明,REBOA 可在 ITCA 患者中进行,如果 REBOA 放置成功,SBP 可以升高,36.6%的患者可以存活。