Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
Department of Anesthesiology and Intensive Care Medicine, St Olavs Hospital University Hospital in Trondheim, Trondheim, Norway.
Emerg Med J. 2022 Jul;39(7):521-526. doi: 10.1136/emermed-2020-210808. Epub 2021 May 26.
Resuscitative endovascular balloon occlusion of the aorta (REBOA) can be used as an adjunct treatment in traumatic abdominopelvic haemorrhage, ruptured abdominal aortic aneurysms, postpartum haemorrhage (PPH), gastrointestinal bleeding and iatrogenic injuries during surgery. This needs assessment study aims to determine the number of patients eligible for REBOA in a typical Norwegian population.
This was a retrospective cross-sectional study based on data obtained from blood bank registries and the Norwegian Trauma Registry for the years 2017-2018. Patients who received ≥4 units of packed red blood cells (PRBCs) within 6 hours and met the anatomical criteria for REBOA or patients with relevant Abbreviated Injury Scale codes with concurrent hypotension or transfusion of ≥4 units of PRBCs within 6 hours were identified. A detailed two-step chart review was performed to identify potentially eligible REBOA candidates. Descriptive data were collected and compared between subgroups using non-parametric tests for statistical significance.
Of 804 patients eligible for inclusion, 53 patients were regarded as potentially REBOA eligible (corresponding to 5.7 per 100 000 adult population/year). Of these, 19 actually received REBOA. Among the identified eligible patients, 44 (83%) had a non-traumatic aetiology. Forty-two patients (79%) were treated at a tertiary care hospital. Fourteen (78%) of the REBOA procedures were due to PPH.
The number of patients potentially eligible for REBOA after haemorrhage is low, and most cases are non-traumatic. Most patients were treated at a tertiary care hospital. The exclusion of non-traumatic patients results in a substantial underestimation of the number of potentially REBOA-eligible patients.
在创伤性腹盆出血、破裂性腹主动脉瘤、产后出血 (PPH)、胃肠道出血和手术期间医源性损伤中，主动脉球囊阻断复苏术 (REBOA) 可用作辅助治疗。本需要评估研究旨在确定在典型的挪威人群中适合 REBOA 的患者人数。
这是一项基于 2017-2018 年血库登记处和挪威创伤登记处的数据的回顾性横断面研究。在 6 小时内接受≥4 单位浓缩红细胞 (PRBC) 的患者，符合 REBOA 的解剖标准，或具有相关简明损伤量表代码且同时伴有低血压或在 6 小时内输注≥4 单位 PRBC 的患者，被认为是符合条件的患者。进行了详细的两步图表审查，以确定潜在的符合 REBOA 条件的患者。收集描述性数据，并使用非参数检验比较亚组之间的差异。
在 804 名符合纳入标准的患者中，有 53 名患者被认为是潜在的 REBOA 合格患者（相当于每年每 10 万成年人口 5.7 例）。其中 19 例实际接受了 REBOA。在确定的合格患者中，44 例（83%）的病因是非创伤性的。42 例（79%）患者在三级护理医院接受治疗。14 例（78%）REBOA 手术是由于 PPH。
出血后潜在适合 REBOA 的患者数量较少，大多数病例是非创伤性的。大多数患者在三级护理医院接受治疗。排除非创伤性患者会导致潜在适合 REBOA 的患者人数被严重低估。
