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国外的可植入式胸腹主动脉阻断术:利用部分主动脉阻断在乌克兰实现稳定与转运

pREBOA Abroad: Leveraging Partial Aortic Occlusion for Stabilization and Transport in Ukraine.

作者信息

Akrish Eric, Meyer Courtney H, Spokiy Volodya, Caddell Erin C, Nguyen Jonathan

机构信息

Emergency Department, Tampa General Hospital, Tampa, USA.

Surgery Department, Emory University School of Medicine, Atlanta, USA.

出版信息

Cureus. 2025 May 20;17(5):e84466. doi: 10.7759/cureus.84466. eCollection 2025 May.

Abstract

The war in Ukraine highlights the challenges in providing combat casualty care when both nations are near-peer adversaries. Providing timely definitive hemorrhage control within one hour of injury, as the US military and its allies have grown accustomed, is unrealistic. Stabilization points (SP) in Ukraine are forced to provide prolonged field care to exsanguinating patients with little resources while waiting extended periods of time for patient transport. pREBOA-PRO™ (Prytime Medical, Boerne, TX)has been suggested as a bridge to this problem as it can provide temporary hemorrhage control, stabilize the patient, and limit distal ischemic consequences when used for partial aortic occlusion. We discuss a patient who suffered a traumatic arm amputation and intra-abdominal injuries managed with pREBOA-PRO™. This partial aortic occlusion provided an increase in central perfusion pressure, temporary hemorrhage control, and time for patient transport to definitive hemorrhage control. This serves as proof of concept that pREBOA-PRO™ and partial aortic occlusion can stabilize a patient, provide longer safe occlusion times, and aid in transport in austere environments while mitigating distal ischemic consequences.

摘要

俄乌冲突凸显了在两国为近似对等对手的情况下提供战斗伤员护理的挑战。像美军及其盟友所习惯的那样,在受伤后一小时内及时进行确定性出血控制是不现实的。乌克兰的稳定点被迫在资源匮乏的情况下为失血过多的患者提供长时间的战地护理,同时要等待很长时间才能将患者转运出去。有人提出pREBOA-PRO™(Prytime Medical公司,得克萨斯州博尔尼)可作为解决这一问题的桥梁,因为在用于部分主动脉闭塞时,它可以提供临时出血控制、稳定患者状况并限制远端缺血后果。我们讨论了一名因创伤性手臂截肢和腹部损伤而接受pREBOA-PRO™治疗的患者。这种部分主动脉闭塞增加了中心灌注压,实现了临时出血控制,并为患者转运至确定性出血控制争取了时间。这证明了pREBOA-PRO™和部分主动脉闭塞能够稳定患者状况,提供更长的安全闭塞时间,并在严峻环境下协助转运,同时减轻远端缺血后果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/55d7/12178089/9040a64b4d2e/cureus-0017-00000084466-i01.jpg

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