Hilbert-Carius Peter, Streibert Fridolin, Ebert Daniel, Vogt Alexander, Beese Matthias, Tongers Jörn, Hofmann Gunther, Braun Jörg
Klinik für Anästhesiologie, Intensiv- und Notfallmedizin, Schmerztherapie, Bergmannstrost BG Klinikum Halle (Saale) gGmbH, Merseburgerstr. 165, 06112, Halle (Saale), Deutschland.
DRF Luftrettung, Station Halle, Christoph Sachsen-Anhalt (CHX 84) und Christoph Halle (CHX 85), Halle (Saale), Deutschland.
Anaesthesiologie. 2023 Dec;72(12):871-877. doi: 10.1007/s00101-023-01359-0. Epub 2023 Nov 24.
Resuscitative endovascular balloon occlusion of the aorta (REBOA) represents an endovascular procedure for aortic occlusion. The procedure can be used for temporary hemorrhage control as a bridge until surgical treatment for noncompressible abdominal or pelvic bleeding and to improve coronary and cerebral perfusion pressure during cardiopulmonary resuscitation. The prehospital administration is challenging and currently hardly possible in Germany. In the REBOA in bleeding and cardiac arrest in the prehospital care by helicopter emergency medical service (RIBCAP-HEMS) project, the prehospital use of REBOA will be tested in a feasibility study. This article describes the training course on the procedure in preparation for prehospital use, which was conducted before the start of the aforementioned feasibility study for the emergency physicians and paramedics (HEMS-TC) of the DRF Air Rescue Base in Halle (Saale). The course provided the necessary theoretical and practical skills to apply REBOA in the prehospital setting to patients in extremis in a safe, indications-conform and time-critical manner. The fact that all emergency physicians of the two air ambulances Christoph 84 and Christoph 85 in Halle are specialists in anesthesiology with corresponding experience in the placement of invasive arterial catheters proved to be advantageous. The training course was able to significantly improve the theoretical and practical abilities of the participants. The results of the currently ongoing study must show whether the procedure can be usefully integrated into the prehospital care of patients in extremis.
主动脉复苏性血管内球囊阻断术（REBOA）是一种用于主动脉阻断的血管内操作。该操作可用于暂时控制出血，作为一种过渡手段，直至对不可压迫的腹部或盆腔出血进行手术治疗，还可在心肺复苏期间提高冠状动脉和脑灌注压。在德国，院前实施具有挑战性，目前几乎无法实现。在“直升机紧急医疗服务中院前出血与心脏骤停的REBOA”（RIBCAP - HEMS）项目中，将在一项可行性研究中测试REBOA的院前应用。本文描述了在上述可行性研究开始之前，为哈雷（萨勒）DRF空中救援基地的急诊医生和护理人员（HEMS - TC）开展的针对院前应用该操作的培训课程。该课程提供了必要的理论和实践技能，以便在院前环境中以安全、符合指征且及时的方式对危重症患者应用REBOA。事实证明，哈雷的两架空中救护直升机Christoph 84和Christoph 85上的所有急诊医生均为麻醉学专家，在放置有创动脉导管方面具有相应经验，这一点很有利。培训课程能够显著提高参与者的理论和实践能力。目前正在进行的研究结果必须表明该操作是否能够有效地融入危重症患者的院前护理中。
