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当主动脉内球囊阻断术“长出翅膀”:主动脉内复苏球囊阻断术助力空中医疗转运

When REBOA grows wings: Resuscitative endovascular balloon occlusion of the aorta to facilitate aeromedical transport.

作者信息

Snyder Jason A, Schuerer Douglas J E, Bochicchio Grant V, Hoofnagle Mark H

机构信息

Department of Surgery, Washington University in Saint Louis, St. Louis, MO, USA.

出版信息

Trauma Case Rep. 2022 Feb 22;38:100622. doi: 10.1016/j.tcr.2022.100622. eCollection 2022 Apr.

DOI:10.1016/j.tcr.2022.100622
PMID:35252526
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8889235/
Abstract

BACKGROUND

Resuscitative endovascular balloon occlusion of the aorta (REBOA) is a helpful adjunct in the control of non-compressible truncal hemorrhage. Concerns regarding ischemia time limits its applicability in transfer. We describe the first reported case of civilian transfer via aeromedical transport to a higher level of care with a zone 3 REBOA catheter deployed.

CASE REPORT

We present the case of a patient in hemorrhagic shock with a complex pelvic fracture exceeding the capability of a rural level-two trauma center requiring the use of REBOA catheter to permit aeromedical transport to a level-one trauma center for definitive embolization.

CONCLUSION

Deployment of REBOA catheter to facilitate aeromedical transport to an appropriate level of care may be considered if travel times can be kept brief and there is a process and training in place to empower flight medics to consider transporting with a REBOA deployed.

摘要

背景

主动脉内复苏球囊阻断术(REBOA)是控制不可压缩性躯干出血的一种有用辅助手段。对缺血的担忧限制了其在转运中的应用。我们描述了首例通过航空医疗转运至更高水平医疗机构且部署了3区REBOA导管的平民患者转运病例。

病例报告

我们报告了一名失血性休克患者的病例,该患者骨盆骨折复杂,超出了农村二级创伤中心的救治能力,需要使用REBOA导管以便通过航空医疗转运至一级创伤中心进行确定性栓塞治疗。

结论

如果转运时间能够保持短暂,并且有相应流程和培训使飞行医护人员能够考虑在部署REBOA的情况下进行转运,那么可以考虑部署REBOA导管以促进航空医疗转运至适当水平的医疗机构。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1c1f/8889235/85aed56cc7d2/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1c1f/8889235/cfcf646137c8/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1c1f/8889235/85aed56cc7d2/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1c1f/8889235/cfcf646137c8/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1c1f/8889235/85aed56cc7d2/gr2.jpg

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本文引用的文献

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Eur J Med Res. 2021 Jan 21;26(1):10. doi: 10.1186/s40001-021-00485-y.
2
Patterns and outcomes of zone 3 REBOA use in the management of severe pelvic fractures: Results from the AAST Aortic Occlusion for Resuscitation in Trauma and Acute Care Surgery database.区域 3 血管内球囊阻断在严重骨盆骨折治疗中的应用模式和结果:来自创伤和急性护理外科学协会主动脉阻塞复苏创伤数据库的结果。
J Trauma Acute Care Surg. 2021 Apr 1;90(4):659-665. doi: 10.1097/TA.0000000000003053.
3
Resuscitative Endovascular Balloon Occlusion of the Aorta vs Pre-Peritoneal Packing in Patients with Pelvic Fracture.
骨盆骨折患者中主动脉复苏性血管内球囊阻断术与腹膜前填塞术的比较
J Am Coll Surg. 2021 Jan;232(1):17-26.e2. doi: 10.1016/j.jamcollsurg.2020.08.763. Epub 2020 Oct 3.
4
Temporal Changes in REBOA Utilization Practices are Associated With Increased Survival: an Analysis of the AORTA Registry.REBOA 使用实践中的时间变化与生存率提高相关:AORTA 注册研究分析。
Shock. 2021 Jan 1;55(1):24-32. doi: 10.1097/SHK.0000000000001586.
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Can Resuscitative Endovascular Balloon Occlusion of the Aorta Fly? Assessing Aortic Balloon Performance for Aeromedical Evacuation.主动脉复苏性血管内球囊阻断术可行吗?评估用于空中医疗后送的主动脉球囊性能。
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