Baylor College of Medicine, School of Medicine, 1 Baylor Plaza, Houston, TX, 77030, USA.
Texas Children's Hospital, Michael E. DeBakey Department of Surgery, Division of Pediatric Surgery, 6701 Fannin St, Houston, TX, 77030, USA.
J Pediatr Surg. 2020 Oct;55(10):2128-2133. doi: 10.1016/j.jpedsurg.2020.01.052. Epub 2020 Feb 1.
Hemorrhage is the main cause of preventable death in both military and civilian trauma, and many of these patients die from non-compressible torso injuries. Resuscitative endovascular balloon occlusion of the aorta (REBOA) is a minimally invasive method used for hemodynamic control of the hemorrhaging patient and has been compared to resuscitative thoracotomy (RT) with cross clamping of the aorta. REBOA has received a great deal of attention in recent years for its applicability and promise in adult trauma and non-trauma settings, but its utility in children is mostly unknown. The purpose of this review article is to summarize and consolidate what is currently known about the use of REBOA in children. Some of the challenges in implementing REBOA in children include small vascular anatomy and lack of outcomes data. Although the evidence is limited, there are established instances in the literature of children and adolescents who have undergone endovascular occlusion of the aorta for hemorrhage control with positive outcomes and survival rates equivalent to their adult counterparts. There is a need for further formal evaluation of REBOA in pediatric patients with prospective studies to look at the safety, feasibility and efficacy of the technique. STUDY TYPE: Narrative Literature Review LEVEL OF EVIDENCE: IV.
出血是军事和民用创伤中可预防死亡的主要原因，其中许多患者死于无法压缩的躯干损伤。主动脉球囊阻断复苏术（REBOA）是一种用于控制出血患者血流动力学的微创方法，已与主动脉交叉夹闭的复苏性开胸术（RT）进行了比较。近年来，REBOA 在成人创伤和非创伤环境中的适用性和潜力引起了广泛关注，但在儿童中的应用知之甚少。本文综述的目的是总结和整合目前已知的 REBOA 在儿童中的应用。在儿童中实施 REBOA 面临的一些挑战包括血管解剖结构小和缺乏结局数据。尽管证据有限，但文献中有明确的实例表明，儿童和青少年因出血控制而接受主动脉血管内闭塞的病例，其结局和生存率与成人相当。需要进一步对儿科患者进行前瞻性研究，以评估 REBOA 的安全性、可行性和疗效。研究类型：叙述性文献综述。证据水平：IV 级。
