International registry on aortic balloon occlusion in major trauma : Partial inflation does not improve outcomes in abdominal trauma
Copyright © 2023 Royal College of Surgeons of Edinburgh (Scottish charity number SC005317) and Royal College of Surgeons in Ireland. Published by Elsevier Ltd. All rights reserved..
BACKGROUND: Resuscitative endovascular balloon occlusion of the aorta (REBOA) is a method for temporary hemorrhage control used in haemodynamically unwell patients with severe bleeding. In haemodynamically unwell abdominal trauma patients, laparotomy remains the initial procedure of choice. Using REBOA in patients as a bridge to laparotomy is a novel option whose feasibility and efficacy remain unclear. We aimed to assess the clinical outcome in patients with abdominal injury who underwent both REBOA placement and laparotomy.
METHODS: This is a retrospective study, including trauma patients with an isolated abdominal injury who underwent both REBOA placement and laparotomy, during the period 2011-2019. All data were collected via the Aortic Balloon Occlusion Trauma Registry database.
RESULTS: One hundred and three patients were included in this study. The main mechanism of trauma was blunt injury (62.1%) and the median injury severity score (ISS) was 33 (14-74). Renal failure and multi-organ dysfunction syndrome (MODS) occurred in 15.5% and 35% of patients, respectively. Overall, 30-day mortality was 50.5%. Post balloon inflation systolic blood pressure (SBP) >80 mmHg was associated with lower 24-h mortality (p = 0.007). No differences in mortality were found among patients who underwent partial occlusion vs. total occlusion of the aorta.
CONCLUSIONS: Our results support the feasibility of REBOA use in patients with isolated abdominal injury, with survival rates similar to previous reports for haemodynamically unstable abdominal trauma patients. Post-balloon inflation SBP >80 mmHg was associated with a significant reduction in 24-h mortality rates, but not 30-day mortality. Total aortic occlusion was not associated with increased mortality, MODS, and complication rates compared with partial occlusion.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2024 |
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| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:22 |
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| Enthalten in: |
The surgeon : journal of the Royal Colleges of Surgeons of Edinburgh and Ireland - 22(2024), 1 vom: 01. Jan., Seite 37-42 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Paran, Maya [VerfasserIn] |
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| Links: |
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| Themen: |
Abdominal trauma |
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| Anmerkungen: |
Date Completed 22.01.2024 Date Revised 22.01.2024 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1016/j.surge.2023.08.001 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM361506163 |
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| 100 | 1 | |a Paran, Maya |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a International registry on aortic balloon occlusion in major trauma |b Partial inflation does not improve outcomes in abdominal trauma |
| 264 | 1 | |c 2024 | |
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| 500 | |a Date Completed 22.01.2024 | ||
| 500 | |a Date Revised 22.01.2024 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2023 Royal College of Surgeons of Edinburgh (Scottish charity number SC005317) and Royal College of Surgeons in Ireland. Published by Elsevier Ltd. All rights reserved. | ||
| 520 | |a BACKGROUND: Resuscitative endovascular balloon occlusion of the aorta (REBOA) is a method for temporary hemorrhage control used in haemodynamically unwell patients with severe bleeding. In haemodynamically unwell abdominal trauma patients, laparotomy remains the initial procedure of choice. Using REBOA in patients as a bridge to laparotomy is a novel option whose feasibility and efficacy remain unclear. We aimed to assess the clinical outcome in patients with abdominal injury who underwent both REBOA placement and laparotomy | ||
| 520 | |a METHODS: This is a retrospective study, including trauma patients with an isolated abdominal injury who underwent both REBOA placement and laparotomy, during the period 2011-2019. All data were collected via the Aortic Balloon Occlusion Trauma Registry database | ||
| 520 | |a RESULTS: One hundred and three patients were included in this study. The main mechanism of trauma was blunt injury (62.1%) and the median injury severity score (ISS) was 33 (14-74). Renal failure and multi-organ dysfunction syndrome (MODS) occurred in 15.5% and 35% of patients, respectively. Overall, 30-day mortality was 50.5%. Post balloon inflation systolic blood pressure (SBP) >80 mmHg was associated with lower 24-h mortality (p = 0.007). No differences in mortality were found among patients who underwent partial occlusion vs. total occlusion of the aorta | ||
| 520 | |a CONCLUSIONS: Our results support the feasibility of REBOA use in patients with isolated abdominal injury, with survival rates similar to previous reports for haemodynamically unstable abdominal trauma patients. Post-balloon inflation SBP >80 mmHg was associated with a significant reduction in 24-h mortality rates, but not 30-day mortality. Total aortic occlusion was not associated with increased mortality, MODS, and complication rates compared with partial occlusion | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Abdominal trauma | |
| 650 | 4 | |a Aortic balloon occlusion | |
| 650 | 4 | |a EVTM | |
| 650 | 4 | |a Morbidity | |
| 650 | 4 | |a Mortality | |
| 650 | 4 | |a REBOA | |
| 700 | 1 | |a McGreevy, David |e verfasserin |4 aut | |
| 700 | 1 | |a Hörer, Tal M |e verfasserin |4 aut | |
| 700 | 1 | |a Khan, Mansoor |e verfasserin |4 aut | |
| 700 | 1 | |a Dudkiewicz, Mickey |e verfasserin |4 aut | |
| 700 | 1 | |a Kessel, Boris |e verfasserin |4 aut | |
| 700 | 0 | |a ABO Trauma Registry research group |e verfasserin |4 aut | |
| 700 | 1 | |a Sadeghi, M |e investigator |4 oth | |
| 700 | 1 | |a Pirouzram, A |e investigator |4 oth | |
| 700 | 1 | |a Toivola, A |e investigator |4 oth | |
| 700 | 1 | |a Skoog, P |e investigator |4 oth | |
| 700 | 1 | |a Idoguchi, K |e investigator |4 oth | |
| 700 | 1 | |a Kon, Y |e investigator |4 oth | |
| 700 | 1 | |a Ishida, T |e investigator |4 oth | |
| 700 | 1 | |a Matsumura, Y |e investigator |4 oth | |
| 700 | 1 | |a Matsumoto, J |e investigator |4 oth | |
| 700 | 1 | |a Maszkowski, M |e investigator |4 oth | |
| 700 | 1 | |a Bersztel, A |e investigator |4 oth | |
| 700 | 1 | |a Caragounis, E C |e investigator |4 oth | |
| 700 | 1 | |a Bachmann, T |e investigator |4 oth | |
| 700 | 1 | |a Falkenberg, M |e investigator |4 oth | |
| 700 | 1 | |a Handolin, L |e investigator |4 oth | |
| 700 | 1 | |a Chang, S W |e investigator |4 oth | |
| 700 | 1 | |a Hecht, A |e investigator |4 oth | |
| 700 | 1 | |a Hebron, D |e investigator |4 oth | |
| 700 | 1 | |a Shaked, G |e investigator |4 oth | |
| 700 | 1 | |a Bala, M |e investigator |4 oth | |
| 700 | 1 | |a Coccolini, F |e investigator |4 oth | |
| 700 | 1 | |a Ansaloni, L |e investigator |4 oth | |
| 700 | 1 | |a Hoencamp, R |e investigator |4 oth | |
| 700 | 1 | |a Özlüer, Y E |e investigator |4 oth | |
| 700 | 1 | |a Hilbert-Carius, Peter |e investigator |4 oth | |
| 700 | 1 | |a Reva, V |e investigator |4 oth | |
| 700 | 1 | |a Oosthuizen, G |e investigator |4 oth | |
| 700 | 1 | |a Szarka, E |e investigator |4 oth | |
| 700 | 1 | |a Manchev, V |e investigator |4 oth | |
| 700 | 1 | |a Wannatoop, T |e investigator |4 oth | |
| 700 | 1 | |a Ordoñez, C A |e investigator |4 oth | |
| 700 | 1 | |a Larzon, T |e investigator |4 oth | |
| 700 | 1 | |a Nilsson, K F |e investigator |4 oth | |
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