Format

Send to

Choose Destination
World J Emerg Surg. 2017 Jul 14;12:30. doi: 10.1186/s13017-017-0142-5. eCollection 2017.

A meta-analysis of resuscitative endovascular balloon occlusion of the aorta (REBOA) or open aortic cross-clamping by resuscitative thoracotomy in non-compressible torso hemorrhage patients.

Author information

1
Clinical Research Center, Fundación Valle del Lili, Cali, Colombia.
2
Clinical Foianini, Santa Cruz de La Sierra, Bolivia.
3
Virginia Commonwealth University, Richmon, VA USA.
4
Universidad del Valle, Cali, Colombia.
5
School of Medicine, Universidad Javeriana Cali, Cali, Valle del Cauca Colombia.
6
Department of Surgery, Brigham and Women's Hospital, Boston, MA USA.
7
Division of Trauma and Acute Care Surgery, Fundación Valle del Lili, Cali, Colombia.

Abstract

BACKGROUND:

The objective of this systematic review and meta-analysis was to determine the effect of REBOA, compared to resuscitative thoracotomy, on mortality and among non-compressible torso hemorrhage trauma patients.

METHODS:

Relevant articles were identified by a literature search in MEDLINE and EMBASE. We included studies involving trauma patients suffering non-compressible torso hemorrhage. Studies were eligible if they evaluated REBOA and compared it to resuscitative thoracotomy. Two investigators independently assessed articles for inclusion and exclusion criteria and selected studies for final analysis. We conducted meta-analysis using random effect models.

RESULTS:

We included three studies in our systematic review. These studies included a total of 1276 patients. An initial analysis found that although lower in REBOA-treated patients, the odds of mortality did not differ between the compared groups (OR 0.42; 95% CI 0.17-1.03). Sensitivity analysis showed that the risk of mortality was significantly lower among patients who underwent REBOA, compared to those who underwent resuscitative thoracotomy (RT) (RR 0.81; 95% CI 0.68-0.97).

CONCLUSION:

Our meta-analysis, mainly from observational data, suggests a positive effect of REBOA on mortality among non-compressible torso hemorrhage patients. However, these results deserve further investigation.

KEYWORDS:

Endovascular procedures; Injuries; Non-compressible torso hemorrhage; REBOA; Resuscitation strategies; Traumatic shock

PMID:
28725258
PMCID:
PMC5512749
DOI:
10.1186/s13017-017-0142-5
[Indexed for MEDLINE]
Free PMC Article

Supplemental Content

Full text links

Icon for BioMed Central Icon for PubMed Central
Loading ...
Support Center