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Feasibility and Clinical Outcome of Reboa in Patients with Impending Traumatic Cardiac Arrest.

Journal article
Authors David Thomas McGreevy
Fikri M Abu-Zidan
Mitra Sadeghi
Artai Pirouzram
Asko Toivola
Per Skoog
Koji Idoguchi
Yuri Kon
Tokiya Ishida
Yosuke Matsumura
Junichi Matsumoto
Viktor Reva
Mariusz Maszkowski
Adam Bersztel
Eva Corina Caragounis
Mårten Falkenberg
Lauri Handolin
George Oosthuizen
Endre Szarka
Vassil Manchev
Tongporn Wannatoop
Sung Wook Chang
Boris Kessel
Dan Hebron
Gad Shaked
Miklosh Bala
Federico Coccolini
Luca Ansaloni
Carlos A Ordoñez
Emanuel M Dogan
James E Manning
Peter Hibert-Carius
Thomas Larzon
Kristofer F Nilsson
Tal Martin Hörer
Published in Shock
ISSN 1540-0514
Publication year 2019
Published at Institute of Clinical Sciences, Department of Surgery
Language en
Links dx.doi.org/10.1097/SHK.000000000000...
www.ncbi.nlm.nih.gov/entrez/query.f...
Subject categories Vascular surgery, Intensive care, Traumatology

Abstract

Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) may improve Systolic Blood Pressure (SBP) in hypovolemic shock. It has, however, not been studied in patients with impending traumatic cardiac arrest (ITCA). We aimed to study the feasibility and clinical outcome of REBOA in patients with ITCA using data from the ABOTrauma Registry.Retrospective and prospective data on the use of REBOA from 16 centers globally were collected. SBP was measured both at pre- and post-REBOA inflation. Data collected included patients' demography, vascular access technique, number of attempts, catheter size, operator, zone and duration of occlusion, and clinical outcome.There were 74 patients in this high-risk patient group. REBOA was performed on all patients. A 7-10Fr catheter was used in 66.7%, 58.5% were placed on the first attempt, 52.1% through blind insertion and 93.2% inflated in Zone I, 64.8% for a period of 30 to 60 minutes, 82.1% by ER doctors, trauma surgeons or vascular surgeons. SBP significantly improved to 90 mmHg following the inflation of REBOA. 36.6% of the patients survived.Our study has shown that REBOA may be performed in patients with ITCA, SBP can be elevated and 36.6% of the patients survived if REBOA placement is successful.

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