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Open Access 01-12-2018 | Research

Resuscitative endovascular balloon occlusion of the aorta performed by emergency physicians for traumatic hemorrhagic shock: a case series from Japanese emergency rooms

Authors: Ryota Sato, Akira Kuriyama, Rei Takaesu, Nobuhiro Miyamae, Wataru Iwanaga, Hayato Tokuda, Takehiro Umemura

Published in: Critical Care | Issue 1/2018

Abstract

Background

Resuscitative endovascular balloon occlusion of the aorta (REBOA), which has been increasingly used for the management of hemorrhagic shock, is a less invasive strategy for the management of patients with very severe hemorrhage. However, its effectiveness remains controversial.

Methods

This retrospective case series included trauma patients who underwent REBOA for hemorrhagic shock due to trauma in four Japanese tertiary care emergency centers from January 2013 to March 2017. Patients in cardiac arrest at the time of REBOA and those who underwent REBOA for nontraumatic causes during the study period were excluded.

Results

A total of 24 patients underwent REBOA during the study period. The median age was 52 years (interquartile range (IQR) 36.5–62.5), 17 (70.8%) of the patients were male, and 23 (95.8%) had blunt trauma. The 24-h survival was 50% (n = 12), and the in-hospital survival rate was 41.7% (10/24). In all cases, REBOA was performed in emergency rooms by emergency physicians without fluoroscopic guidance. Complications of REBOA were mesenteric ischemia (n = 1, 4.2%), ischemia of the lower extremities (n = 1, 4.2%), and placement of REBOA in thoracic aortic injury (n = 3, 12.5%).

Conclusions

REBOA can be an effective and feasible tool for controlling massive hemorrhage due to trauma. However, caution should be exercised regarding complications including placement of REBOA in aortic injury and limb ischemia in cases where REBOA is performed in an emergency department setting with minimal or no support from trauma surgeons.

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Title: Resuscitative endovascular balloon occlusion of the aorta performed by emergency physicians for traumatic hemorrhagic shock: a case series from Japanese emergency rooms
Authors: Ryota Sato
Akira Kuriyama
Rei Takaesu
Nobuhiro Miyamae
Wataru Iwanaga
Hayato Tokuda
Takehiro Umemura
Publication date: 01-12-2018
Publisher: BioMed Central
Published in: Critical Care / Issue 1/2018
Electronic ISSN: 1364-8535
DOI: https://doi.org/10.1186/s13054-018-2032-y

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Resuscitative endovascular balloon occlusion of the aorta performed by emergency physicians for traumatic hemorrhagic shock: a case series from Japanese emergency rooms

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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