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The use of aortic balloon occlusion in traumatic shock: first report from the ABO trauma registry
Örebro University, School of Medical Sciences. Västmanlands Hospital, Västerås, Sweden; Department of Vascular Surgery, Faculty of Health and Medical Sciences, Örebro University, Örebro, Sweden.
Örebro University, School of Medical Sciences. Örebro University Hospital. Department of Cardiothoracic and Vascular Surgery.ORCID iD: 0000-0002-8461-5074
Department of Cardiothoracic and Vascular Surgery, Örebro University Hospital, Örebro, Sweden.
Örebro University, School of Medical Sciences. Department of Cardiothoracic and Vascular Surgery.
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2018 (English)In: European Journal of Trauma and Emergency Surgery, ISSN 1863-9933, E-ISSN 1863-9941, Vol. 44, no 4, p. 491-501Article in journal (Refereed) Published
Abstract [en]

PURPOSE: Resuscitative endovascular balloon occlusion of the aorta (REBOA) is a technique for temporary stabilization of patients with non-compressible torso hemorrhage. This technique has been increasingly used worldwide during the past decade. Despite the good outcomes of translational studies, clinical studies are divided. The aim of this multicenter-international study was to capture REBOA-specific data and outcomes.

METHODS: REBOA practicing centers were invited to join this online register, which was established in September 2014. REBOA cases were reported, both retrospective and prospective. Demographics, injury patterns, hemodynamic variables, REBOA-specific data, complications and 30-days mortality were reported.

RESULTS: Ninety-six cases from 6 different countries were reported between 2011 and 2016. Mean age was 52 ± 22 years and 88% of the cases were blunt trauma with a median injury severity score (ISS) of 41 (IQR 29-50). In the majority of the cases, Zone I REBOA was used. Median systolic blood pressure before balloon inflation was 60 mmHg (IQR 40-80), which increased to 100 mmHg (IQR 80-128) after inflation. Continuous occlusion was applied in 52% of the patients, and 48% received non-continuous occlusion. Occlusion time longer than 60 min was reported as 38 and 14% in the non-continuous and continuous groups, respectively. Complications, such as extremity compartment syndrome (n = 3), were only noted in the continuous occlusion group. The 30-day mortality for non-continuous REBOA was 48%, and 64% for continuous occlusion.

CONCLUSIONS: This observational multicenter study presents results regarding continuous and non-continuous REBOA with favorable outcomes. However, further prospective studies are needed to be able to draw conclusions on morbidity and mortality.

Place, publisher, year, edition, pages
Springer Berlin/Heidelberg, 2018. Vol. 44, no 4, p. 491-501
Keywords [en]
Aortic occlusion, Hemorrhage, IABO, REBOA, Trauma
National Category
Surgery
Identifiers
URN: urn:nbn:se:oru:diva-61724DOI: 10.1007/s00068-017-0813-7ISI: 000440981100002PubMedID: 28801841Scopus ID: 2-s2.0-85027305588OAI: oai:DiVA.org:oru-61724DiVA, id: diva2:1155214
Funder
Swedish Society for Medical Research (SSMF)
Note

Funding Agencies:

Research Committee of Region Örebro County  

Nyckelfonden at Örebro University Hospital  

ALF Grants (Agreement concerning research and education of doctors)  

Region Örebro County 

Available from: 2017-11-07 Created: 2017-11-07 Last updated: 2018-09-14Bibliographically approved

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Sadeghi, MitraNilsson, Kristofer F.Pirouzram, Artai

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