Global InformationResuscitative endovascular balloon occlusion of the aorta information
| Resuscitative endovascular balloon occlusion of the aorta | |
|---|---|
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| Specialty | Trauma Surgery, Vascular Surgery, Emergency Medicine, Interventional Radiology |
| Uses | Severe hemorrhage, non-compressible torso hemorrhage, pelvic hemorrhage, obstetric hemorrhage, gastrointestinal hemorrhage. |
| Other options | Emergency Thoracotomy with Aortic Cross Clamping |
Resuscitative endovascular balloon occlusion of the aorta (REBOA) is a minimally invasive procedure performed during resuscitation of critically injured trauma patients. Originally developed as a less invasive alternative to emergency thoracotomy with aortic cross clamping, REBOA is performed to gain rapid control of non-compressible truncal or junctional hemorrhage.[1][2] REBOA is performed first by achieving access to the common femoral artery (CFA) and advancing a catheter within the aorta.[1] Upon successful catheter placement, an occluding balloon may be inflated either within the descending thoracic aorta (Zone 1) or infrarenal abdominal aorta (Zone 3).[1][2] REBOA stanches downstream hemorrhage and improves cardiac index, cerebral perfusion, and coronary perfusion.[1][3][4] Although REBOA does not eliminate the need for definitive hemorrhage control, it may serve as a temporizing measure during initial resuscitation.[1] Despite the benefits of REBOA, there are significant local and systemic ischemic risks.[1][5] Establishing standardized REBOA procedural indications and mitigating the risk of ischemic injury are topics of ongoing investigation.[1][4] Although this technique has been successfully deployed in adult patients, it has not yet been studied in children.[6]
- ^ a b c d e f g Glaser J, Stigall K, Cannon J, Jensen S, Morrison JJ, Snyder S, Russo R, Manley J, Becker T, Dubose J (2020-03-30). "Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) for Hemorrhagic Shock (CPG ID:38)" (PDF). Joint Trauma System Clinical Practice Guidelines (CPG ID:38). Retrieved March 13, 2023.
- ^ a b Castellini G, Gianola S, Biffi A, Porcu G, Fabbri A, Ruggieri MP, et al. (August 2021). "Resuscitative endovascular balloon occlusion of the aorta (REBOA) in patients with major trauma and uncontrolled haemorrhagic shock: a systematic review with meta-analysis". World Journal of Emergency Surgery. 16 (1): 41. doi:10.1186/s13017-021-00386-9. PMC 8358549. PMID 34384452.
- ^ Russo RM, White JM, Baer DG (June 2021). "Partial Resuscitative Endovascular Balloon Occlusion of the Aorta: A Systematic Review of the Preclinical and Clinical Literature". The Journal of Surgical Research. 262: 101–114. doi:10.1016/j.jss.2020.12.054. PMID 33561721.
- ^ a b Borger van der Burg BL, van Dongen TT, Morrison JJ, Hedeman Joosten PP, DuBose JJ, Hörer TM, Hoencamp R (August 2018). "A systematic review and meta-analysis of the use of resuscitative endovascular balloon occlusion of the aorta in the management of major exsanguination". European Journal of Trauma and Emergency Surgery. 44 (4): 535–550. doi:10.1007/s00068-018-0959-y. PMC 6096615. PMID 29785654.
- ^ Cochran C. "ISRCTN - ISRCTN16184981: The effectiveness and cost-effectiveness of Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) for trauma". www.isrctn.com. doi:10.1186/ISRCTN16184981. Retrieved 2018-02-25.
- ^ Yamashiro KJ, Galganski LA, Grayson JK, Johnson MA, Beyer CA, Spruce MW, et al. (October 2020). "Resuscitative endovascular balloon occlusion of the aorta in a pediatric swine model: Is 60 minutes too long?". The Journal of Trauma and Acute Care Surgery. 89 (4): 616–622. doi:10.1097/TA.0000000000002620. PMID 32068720. S2CID 211160046.