scholarly journals Resuscitative endovascular balloon occlusion of the aorta (REBOA): an updated review

2018 ◽  
Vol 45 (1) ◽  
Author(s):  
MARCELO AUGUSTO FONTENELLE RIBEIRO JÚNIOR ◽  
MEGAN BRENNER ◽  
ALEXANDER T. M. NGUYEN ◽  
CÉLIA Y. D. FENG ◽  
RAÍSSA REIS DE-MOURA ◽  
...  
Keyword(s):  
Causes Of Death ◽  
Balloon Occlusion ◽  
Trauma Patients ◽  
Trauma Centers ◽  
Current Scenario ◽  
Trauma Injury ◽  
Ideal Method ◽  
Endovascular Balloon Occlusion ◽  
A Current ◽  
The Ideal

ABSTRACT In a current scenario where trauma injury and its consequences account for 9% of the worlds causes of death, the management of non-compressible torso hemorrhage can be problematic. With the improvement of medicine, the approach of these patients must be accurate and immediate so that the consequences may be minimal. Therefore, aiming the ideal method, studies have led to the development of Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA). This procedure has been used at select trauma centers as a resuscitative adjunct for trauma patients with non-compressible torso hemorrhage. Although the use of this technique is increasing, its effectiveness is still not clear. This article aims, through a detailed review, to inform an updated view about this procedure, its technique, variations, benefits, limitations and future.

scholarly journals Feasibility of REBOA—Resuscitative Endovascular Balloon Occlusion of the Aorta—in Trauma-Related Noncompressible Torso Hemorrhage at Two Metropolitan Trauma Centers

2018 ◽  
Vol 18 (3) ◽  
pp. 201-203 ◽  
Author(s):  
Glenn Ryan ◽  
Kate Swift ◽  
Frances Williamson ◽  
Elissa Scriven ◽  
Olivia Zheng ◽  
...  
Keyword(s):  
Balloon Occlusion ◽  
Trauma Centers ◽  
Endovascular Balloon Occlusion

scholarly journals Assessing the need for resuscitative endovascular balloon occlusion of the aorta (REBOA) for management of non-compressible hemorrhage at a Canadian urban trauma centre

2021 ◽  
Author(s):  
Elizabeth Purssell ◽  
Sean Patrick ◽  
Joseph Haegert ◽  
Vesna Ivkov ◽  
John Taylor
Keyword(s):  
Injury Severity ◽  
Retrospective Chart Review ◽  
Balloon Occlusion ◽  
Trauma Centre ◽  
Trauma Patients ◽  
Potential Candidate ◽  
Study Objective ◽  
Resuscitative Thoracotomy ◽  
Less Invasive ◽  
Endovascular Balloon Occlusion

Abstract Introduction Resuscitative endovascular balloon occlusion of the aorta (REBOA) is a less invasive alternative to resuscitative thoracotomy (RT) for life threatening, infra-diaphragmatic, non-compressible hemorrhage from trauma. Existing evidence surrounding the efficacy of REBOA is conflicting; nevertheless, expert consensus suggests that REBOA should be considered in select trauma patients. There has been a paucity of studies that evaluate the potential utility of REBOA in the Canadian setting. The study objective was to evaluate the percentage of trauma patients presenting to a Level 1 Canadian trauma centre that would have met criteria for REBOA. Methods We conducted a retrospective chart review of patients recorded in the British Columbia Trauma Registry who warranted a trauma team activation (TTA) at our institution. We identified REBOA candidates using pre-defined criteria based on published guidelines. Each TTA case was screened by a reviewer, and then each Potential Candidate was reviewed by a panel of trauma physicians for determination of final candidacy. Results Fourteen patients were classified as Likely REBOA Candidates (2.2% of TTAs, median age 46.1 years, 64.3% female). These patients had a median Injury Severity Score of 31.5 (IQR 26.8). The main sources of hemorrhage in these patients were from abdominal injuries (71.4%) and pelvic fractures (42.9%). Conclusion The percentage of patients who met criteria for REBOA is similar to that of RTs performed at our Canadian institution. While REBOA would be performed infrequently, it is a less-invasive alternative to RT, which could be a potentially life-saving procedure in a small group of the most severely injured trauma patients.

A meta-analysis of the incidence of complications associated with groin access after the use of resuscitative endovascular balloon occlusion of the aorta in trauma patients

2018 ◽  
Vol 85 (3) ◽  
pp. 626-634 ◽  
Author(s):  
Ramiro Manzano-Nunez ◽  
Claudia P. Orlas ◽  
Juan P. Herrera-Escobar ◽  
Samuel Galvagno ◽  
Joseph DuBose ◽  
...  
Keyword(s):  
Meta Analysis ◽  
Balloon Occlusion ◽  
Trauma Patients ◽  
Endovascular Balloon Occlusion

Resuscitative Endovascular Balloon Occlusion of the Aorta vs Pre-Peritoneal Packing in Trauma Patients with Pelvic Fracture

2020 ◽  
Vol 231 (4) ◽  
pp. S329-S330
Author(s):  
Samer Asmar ◽  
Muhammad Khurrum ◽  
Andrew Liang Tang ◽  
Letitia Bible ◽  
Narong Kulvatunyou ◽  
...  
Keyword(s):  
Pelvic Fracture ◽  
Balloon Occlusion ◽  
Trauma Patients ◽  
Endovascular Balloon Occlusion

scholarly journals Resuscitative Endovascular Balloon Occlusion of the Aorta is a Risk Factor for Intestinal Necrosis: A Case Report

2020 ◽  
Author(s):  
Keitaro Yajima ◽  
Shokei Matsumoto ◽  
Motoyasu Yamazaki
Keyword(s):  
Case Reports ◽  
Severe Trauma ◽  
Balloon Occlusion ◽  
Trauma Patients ◽  
Occlusion Time ◽  
Intestinal Necrosis ◽  
Ischemic Complications ◽  
Inappropriate Utilization ◽  
Enhanced Computed Tomography ◽  
Endovascular Balloon Occlusion

Abstract BackgroundResuscitative endovascular balloon occlusion of the aorta (REBOA) is effective for temporary hemorrhage control and resuscitative effort, as it enhances cerebral and coronary circulation in trauma patients. However, an inappropriate utilization of REBOA leads to critical complications. Placement of the balloon in Zone 2 of the aorta should be avoided as the occlusion restricts the intestinal blood supply leading to fatal complications. There is a scarcity of case reports on complications associated with endovascular balloon occlusion in the literature. Here, we have presented a rare case in which Zone 2 REBOA contributed to an ischemic complication in a trauma patient.Case presentationA 50-year-old man with severe trauma, who accidentally got buried under a fallen cement wall, was carried to the nearest hospital. Contrast-enhanced computed tomography showed an unstable pelvic fracture that required hemostatic intervention. Prior to being transferred to another hospital, the patient was treated with endovascular balloon placement. A Zone 2 endovascular balloon placement with resuscitative effort accidentally led to insufficient abdominal blood flow and he developed extensive intestinal necrosis. Following surgical intervention, the patient was resuscitated; however, he developed partial intestinal necrosis and was subsequently managed with surgical intestinal resection.ConclusionsBlood supply to the abdominal organs should be considered when deploying the balloon. Further, balloon positioning, aortic occlusion time, and inflation volume should be carefully considered to avoid ischemic complications.

scholarly journals Distal organ inflammation and injury after resuscitative endovascular balloon occlusion of the aorta in a porcine model of severe hemorrhagic shock

PLoS ONE ◽  
2020 ◽  
Vol 15 (11) ◽  
pp. e0242450
Author(s):  
Yansong Li ◽  
Michael A. Dubick ◽  
Zhangsheng Yang ◽  
Johnny L. Barr ◽  
Brandon J. Gremmer ◽  
...  
Keyword(s):  
Adverse Effects ◽  
Ischemia Reperfusion Injury ◽  
Ischemia Reperfusion ◽  
Positive Control ◽  
Balloon Occlusion ◽  
Organ Injury ◽  
Trauma Patients ◽  
Total Blood ◽  
Shed Blood ◽  
Endovascular Balloon Occlusion

Background and objective Resuscitative Endovascular Balloon Occlusion of Aorta (REBOA) has emerged as a potential life-saving maneuver for the management of non-compressible torso hemorrhage in trauma patients. Complete REBOA (cREBOA) is inherently associated with the burden of ischemia reperfusion injury (IRI) and organ dysfunction. However, the distal organ inflammation and its association with organ injury have been little investigated. This study was conducted to assess these adverse effects of cREBOA following massive hemorrhage in swine. Methods Spontaneously breathing and consciously sedated Sinclair pigs were subjected to exponential hemorrhage of 65% total blood volume over 60 minutes. Animals were randomized into 3 groups (n = 7): (1) Positive control (PC) received immediate transfusion of shed blood after hemorrhage, (2) 30min-cREBOA (A30) received Zone 1 cREBOA for 30 minutes, and (3) 60min-cREBOA (A60) given Zone 1 cREBOA for 60 minutes. The A30 and A60 groups were followed by resuscitation with shed blood post-cREBOA and observed for 4h. Metabolic and hemodynamic effects, coagulation parameters, inflammatory and end organ consequences were monitored and assessed. Results Compared with 30min-cREBOA, 60min-cREBOA resulted in (1) increased IL-6, TNF-α, and IL-1β in distal organs (kidney, jejunum, and liver) (p < 0.05) and decreased reduced glutathione in kidney and liver (p < 0.05), (2) leukopenia, neutropenia, and coagulopathy (p < 0.05), (3) blood pressure decline (p < 0.05), (4) metabolic acidosis and hyperkalemia (p < 0.05), and (5) histological injury of kidney and jejunum (p < 0.05) as well as higher levels of creatinine, AST, and ALT (p < 0.05). Conclusion 30min-cREBOA seems to be a feasible and effective adjunct in supporting central perfusion during severe hemorrhage. However, prolonged cREBOA (60min) adverse effects such as distal organ inflammation and injury must be taken into serious consideration.

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