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鼻衄球囊:MAUDE数据库综合分析

Nasal Epistaxis Balloons: A Comprehensive MAUDE Database Analysis.

作者信息

Merrill Tyler B, Pool Christopher D, Saadi Robert A, Patel Vijay A

机构信息

Department of Otolaryngology - Head and Neck Surgery, University of Arkansas for Medical Sciences, USA.

Kaiser Permanente Orange County, Irvine, CA, USA.

出版信息

Am J Otolaryngol. 2024 Jan-Feb;45(1):104069. doi: 10.1016/j.amjoto.2023.104069. Epub 2023 Sep 28.

Abstract

BACKGROUND

While nasal epistaxis balloons are generally seen as safe and routinely utilized by both surgical and nonsurgical providers, the complication profile related to this type of device has not been well defined.

OBJECTIVE

The objective of this study was to utilize the FDA MAUDE (Manufacturer and User Facility Device Experience) database to better assess adverse events (AE) related to use of nasal epistaxis balloons. Reports were individually tabulated and events were categorized with special attention to AEs.

METHODS

The FDA MAUDE database was queried for all medical device reports (MDR) related to nasal epistaxis balloon devices from January 2012 to November 2022.

RESULTS

19 MDRs met inclusion criteria. 5 MDRs were classified as device related (26.3 %); two events were reported for balloon leak and deflation, two events were reported for device breakage, and one device related event was unknown. 14 MDRs (73.7 %) were classified as patient related. Two documented MDRs were patient deaths due to exsanguination. Additional serious AEs included balloon ingestion and subsequent small bowel perforation (n = 1), cerebrospinal fluid leak (n = 1), skull base violation and intracranial placement of the device (n = 1), and respiratory distress (n = 3).

CONCLUSION

Though epistaxis control with nasal balloons is generally seen as a safe procedure, there have been several concerning AEs reported. While two reports of death due to exsanguination were the most severe AEs, multiple other life-threatening AEs were also documented. Increased awareness of associated complications can be used to better counsel patients during the informed consent process as well as providers in their clinical decision making.

摘要

背景

虽然鼻出血球囊通常被认为是安全的,并且外科和非外科医疗人员都经常使用,但与这类器械相关的并发症情况尚未得到明确界定。

目的

本研究的目的是利用美国食品药品监督管理局(FDA)的MAUDE(制造商和用户设施器械经验)数据库,更好地评估与使用鼻出血球囊相关的不良事件(AE)。对报告进行单独列表,并对事件进行分类,特别关注不良事件。

方法

查询FDA的MAUDE数据库,以获取2012年1月至2022年11月期间与鼻出血球囊器械相关的所有医疗器械报告(MDR)。

结果

19份MDR符合纳入标准。5份MDR被归类为与器械相关(26.3%);报告了两起球囊泄漏和放气事件,两起器械破损事件,还有一起与器械相关的事件不明。14份MDR(73.7%)被归类为与患者相关。两份有记录的MDR是患者因失血死亡。其他严重不良事件包括球囊误吞及随后的小肠穿孔(n = 1)、脑脊液漏(n = 1)、颅底侵犯及器械颅内置入(n = 1)和呼吸窘迫(n = 3)。

结论

虽然使用鼻球囊控制鼻出血通常被视为一种安全的操作,但已有多起令人担忧的不良事件报告。虽然两起失血死亡报告是最严重的不良事件,但也记录了其他多种危及生命的不良事件。提高对相关并发症的认识,可用于在知情同意过程中更好地为患者提供咨询,并帮助医疗人员进行临床决策。

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