Chang Ye Rim, Park Chan Yong, Kim Dong Hun, Ma Dae Sung, Chang Sung Wook
Department of Trauma Surgery, Trauma Center, Dankook University Hospital, Cheonan, Korea.
Department of Trauma Surgery, Wonkwang University Hospital, Iksan, Korea.
Ann Surg Treat Res. 2020 Dec;99(6):362-369. doi: 10.4174/astr.2020.99.6.362. Epub 2020 Nov 26.
Resuscitative endovascular balloon occlusion of the aorta (REBOA) has emerged as a salvage technique changing the paradigm in the management of noncompressible torso hemorrhage. However, training for the REBOA procedure is rarely performed. The endovascular training for REBOA (ET-REBOA) course was conducted to develop the endovascular skills of participants.
Sixteen residents and 12 specialists participated in this educational course. All participants were provided with precourse learning materials. The ET-REBOA course consisted of 2 sections; an ultrasound-guided sheath insertion on the puncture model, and a balloon manipulation on the vascular circuit model. A 13-item procedure checklist and the time required to perform the procedure were examined. Pre/post self-reported confidence score and course satisfaction questionnaire were obtained.
Twenty-eight participants performed the 56 REBOA procedures. On the first attempt, the median total time for REBOA from ultrasound-guided vascular access to balloon inflation was 1,139 ± 250 seconds in the resident group and 828 ± 280 seconds in the specialist group. The median shortened time for completion was 273 seconds and 290 seconds respectively. A significant decrease in procedure task time was observed between first and second attempts in the resident group (P = 0.016), specialist group (P = 0.004), and in total among all participants (P < 0.001).
The ET-REBOA course significantly decreased the time taken to perform the REBOA procedure with high satisfaction of the participants. The course could be an effective curriculum for the development of endovascular skills for performing REBOA.
复苏性血管内主动脉球囊阻断术（REBOA）已成为一种挽救技术，改变了不可压缩性躯干出血的管理模式。然而，针对REBOA手术的培训很少进行。开展血管内REBOA培训（ET - REBOA）课程是为了培养参与者的血管内技能。
16名住院医师和12名专科医生参加了这一教育课程。所有参与者都获得了课前学习材料。ET - REBOA课程包括两个部分：在穿刺模型上进行超声引导下的鞘管插入，以及在血管回路模型上进行球囊操作。检查了一份包含13项内容的操作清单以及完成操作所需的时间。获取了自我报告的课前/课后信心评分和课程满意度问卷。
28名参与者进行了56次REBOA手术。首次尝试时，住院医师组从超声引导下血管穿刺到球囊充气的REBOA总时间中位数为1139±250秒，专科医生组为828±280秒。完成操作缩短时间的中位数分别为273秒和290秒。住院医师组（P = 0.016）、专科医生组（P = 0.004）以及所有参与者总体（P < 0.001）在首次和第二次尝试之间观察到操作任务时间显著减少。
ET - REBOA课程显著减少了进行REBOA手术所需的时间，参与者满意度很高。该课程可能是一种培养进行REBOA血管内技能的有效课程。
