Consensus on resuscitative endovascular balloon occlusion of the aorta (REBOA) in civilian (pre-hospital) trauma care : a Delphi study
Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved..
BACKGROUND: REBOA could prevent lethal exsanguination and support cardiopulmonary resuscitation. In pre-hospital trauma and medical emergency settings, a small population with high mortality rates could potentially benefit from early REBOA deployment. However, its use in these situations remains highly disputed. Since publication of the first Delphi study on REBOA, in which consensus was not reached on all addressed topics, new literature has emerged. Aim of this study was to establish consensus on the use and implementation of REBOA in civilian pre-hospital settings for non-compressible truncal hemorrhage and out-of-hospital cardiac arrest as well as for various in-hospital settings.
METHODS: A Delphi study consisting of three rounds of questionnaires was conducted based on a review of recent literature. REBOA-experts with different medical specialties, backgrounds and work environments were invited for the international panel. Consensus was reached when a minimum of 75% of panelists responded to a question and at least 75% (positive) or less than 25% (negative) of these respondents agreed on the questioned subject.
RESULTS: Panel members reached consensus on potential (contra-)indications, physiological thresholds for patient selection, the use of ultrasound and practical, and technical aspects for early femoral artery access and pre-hospital REBOA.
CONCLUSION: The international expert panel agreed that REBOA can be used in civilian pre-hospital settings for temporary control of non-compressible truncal hemorrhage, provided that personnel are properly trained and protocols are established. For pre-hospital REBOA and early femoral artery access, consensus was reached on (contra-) indications, physiological thresholds and practical aspects. The panel recommends the initiation of a randomized clinical trial investigating the use of pre-hospital REBOA for non-compressible truncal hemorrhage.
LEVEL OF EVIDENCE: Delphi study (original research, care management), level 5.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2024 |
|---|---|
| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - year:2024 |
|---|---|
| Enthalten in: |
The journal of trauma and acute care surgery - (2024) vom: 26. Jan. |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
van de Voort, Jan C [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
|---|
| Anmerkungen: |
Date Revised 26.01.2024 published: Print-Electronic Citation Status Publisher |
|---|
| doi: |
10.1097/TA.0000000000004238 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM367182300 |
|---|
| LEADER | 01000caa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM367182300 | ||
| 003 | DE-627 | ||
| 005 | 20240126232135.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 240117s2024 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1097/TA.0000000000004238 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1271.xml |
| 035 | |a (DE-627)NLM367182300 | ||
| 035 | |a (NLM)38227678 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a van de Voort, Jan C |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Consensus on resuscitative endovascular balloon occlusion of the aorta (REBOA) in civilian (pre-hospital) trauma care |b a Delphi study |
| 264 | 1 | |c 2024 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Revised 26.01.2024 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status Publisher | ||
| 520 | |a Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved. | ||
| 520 | |a BACKGROUND: REBOA could prevent lethal exsanguination and support cardiopulmonary resuscitation. In pre-hospital trauma and medical emergency settings, a small population with high mortality rates could potentially benefit from early REBOA deployment. However, its use in these situations remains highly disputed. Since publication of the first Delphi study on REBOA, in which consensus was not reached on all addressed topics, new literature has emerged. Aim of this study was to establish consensus on the use and implementation of REBOA in civilian pre-hospital settings for non-compressible truncal hemorrhage and out-of-hospital cardiac arrest as well as for various in-hospital settings | ||
| 520 | |a METHODS: A Delphi study consisting of three rounds of questionnaires was conducted based on a review of recent literature. REBOA-experts with different medical specialties, backgrounds and work environments were invited for the international panel. Consensus was reached when a minimum of 75% of panelists responded to a question and at least 75% (positive) or less than 25% (negative) of these respondents agreed on the questioned subject | ||
| 520 | |a RESULTS: Panel members reached consensus on potential (contra-)indications, physiological thresholds for patient selection, the use of ultrasound and practical, and technical aspects for early femoral artery access and pre-hospital REBOA | ||
| 520 | |a CONCLUSION: The international expert panel agreed that REBOA can be used in civilian pre-hospital settings for temporary control of non-compressible truncal hemorrhage, provided that personnel are properly trained and protocols are established. For pre-hospital REBOA and early femoral artery access, consensus was reached on (contra-) indications, physiological thresholds and practical aspects. The panel recommends the initiation of a randomized clinical trial investigating the use of pre-hospital REBOA for non-compressible truncal hemorrhage | ||
| 520 | |a LEVEL OF EVIDENCE: Delphi study (original research, care management), level 5 | ||
| 650 | 4 | |a Journal Article | |
| 700 | 1 | |a Kessel, Boris |e verfasserin |4 aut | |
| 700 | 1 | |a Borger van der Burg, Boudewijn L S |e verfasserin |4 aut | |
| 700 | 1 | |a DuBose, Joseph J |e verfasserin |4 aut | |
| 700 | 1 | |a Hörer, Tal M |e verfasserin |4 aut | |
| 700 | 1 | |a Hoencamp, Rigo |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t The journal of trauma and acute care surgery |d 2012 |g (2024) vom: 26. Jan. |w (DE-627)NLM207894787 |x 2163-0763 |7 nnns |
| 773 | 1 | 8 | |g year:2024 |g day:26 |g month:01 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1097/TA.0000000000004238 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |j 2024 |b 26 |c 01 | ||