Kinslow Kyle, Shepherd Aaron, McKenney Mark, Elkbuli Adel
Department of Surgery, Division of Trauma and Surgical Critical Care, 14506Kendall Regional Medical Center, Miami, FL, USA.
Am Surg. 2022 Feb;88(2):289-296. doi: 10.1177/0003134820972985. Epub 2021 Feb 19.
The data on resuscitative endovascular balloon occlusion of the aorta (REBOA) use continue to grow with its increasing use in trauma centers. The data in her last 5 years have not been systematically reviewed. We aim to assess current literature related to REBOA use and outcomes among civilian trauma populations.
A literature search using PubMed, EMBASE, and JAMA Network for studies regarding REBOA usage in civilian trauma from 2016 to 2020 is carried out. This review followed preferred reporting items for systematic reviews and meta-analysis guidelines.
Our search yielded 35 studies for inclusion in our systematic review, involving 4073 patients. The most common indication for REBOA was patient presentation in hemorrhagic shock secondary to traumatic injury. REBOA was associated with significant systolic blood pressure improvement. Of 4 studies comparing REBOA to non-REBOA controls, 2 found significant mortality benefit with REBOA. Significant mortality improvement with REBOA compared to open aortic occlusion was seen in 4 studies. In the few studies investigating zone placement, highest survival rate was seen in patients undergoing zone 3. Overall, reports of complications directly related to overall REBOA use were relatively low.
REBOA has been shown to be effective in promoting hemodynamic stability in civilian trauma. Mortality data on REBOA use are conflicting, but most studies investigating REBOA vs. open occlusion methods suggest a significant survival advantage. Recent data on the REBOA technique (zone placement and partial REBOA) are sparse and currently insufficient to determine advantage with any particular variation. Overall, larger prospective civilian trauma studies are needed to better understand the benefits of REBOA in high-mortality civilian trauma populations.
Systematic Review.
III- Therapeutic.
随着复苏性血管内主动脉球囊阻断术（REBOA）在创伤中心的使用日益增加，其应用数据也在不断增长。过去5年的数据尚未得到系统回顾。我们旨在评估与平民创伤人群中REBOA使用及结果相关的现有文献。
利用PubMed、EMBASE和JAMA网络对2016年至2020年期间关于平民创伤中REBOA使用情况的研究进行文献检索。本综述遵循系统评价和Meta分析的首选报告项目指南。
我们的检索得到35项研究纳入系统评价，涉及4073例患者。REBOA最常见的适应证是创伤性损伤继发失血性休克的患者表现。REBOA与收缩压显著改善相关。在4项将REBOA与非REBOA对照进行比较的研究中，2项发现REBOA有显著的死亡率获益。4项研究显示，与开放主动脉阻断相比，REBOA有显著的死亡率改善。在少数研究区域放置的研究中，3区患者的生存率最高。总体而言，与REBOA总体使用直接相关的并发症报告相对较少。
REBOA已被证明在促进平民创伤的血流动力学稳定方面有效。关于REBOA使用的死亡率数据存在冲突，但大多数比较REBOA与开放阻断方法的研究表明有显著的生存优势。关于REBOA技术（区域放置和部分REBOA）的最新数据稀少，目前不足以确定任何特定变体的优势。总体而言，需要更大规模的前瞻性平民创伤研究，以更好地了解REBOA在高死亡率平民创伤人群中的益处。
系统评价。
III-治疗性。
