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World J Emerg Surg. 2017 Aug 29;12:42. doi: 10.1186/s13017-017-0153-2. eCollection 2017.

Resuscitative Endovascular Balloon Occlusion of the Aorta in trauma: a systematic review of the literature.

Author information

1
Anesthesia and Intensive Care Department, AUSL Romagna Trauma Center "Maurizio Bufalini" Hospital, Viale Ghirotti 286, 47521 Cesena, Italy.
2
General and Emergency Surgery Department, ASST Trauma Center "Papa Giovanni XXIII" Hospital, Piazza OMS 1, 24127 Bergamo, Italy.
3
Emergency Medicine, University of Modena and Reggio Emilia, via Università 4, 41121 Modena, Italy.
4
Interventional Radiology Department, AUSL Romagna Trauma Center "Maurizio Bufalini" Hospital, Viale Ghirotti 286, 47521 Cesena, Italy.
5
General and Emergency Surgery Department, AUSL Romagna Trauma Center "Maurizio Bufalini" Hospital, Viale Ghirotti 286, 47521 Cesena, Italy.
6
Cardiothoracic and Vascular Surgery Department, Örebro University Hospital, Södra Grev Rosengatan, 701 85 Örebro, Sweden.
7
Anesthesia, Intensive Care and 118 Emergency System Department, AUSL Bologna Trauma Center "Maggiore" Hospital, Largo Nigrisoli 2, 40133 Bologna, Italy.
8
Emergency Medicine Department, AUSL Modena Trauma Center "Sant'Agostino" Hospital, Via Pietro Giardini 1355, 41126 Modena, Italy.

Abstract

AIMS:

Resuscitative endovascular balloon occlusion of the aorta has been a hot topic in trauma resuscitation during these last years. The aims of this systematic review are to analyze when, how, and where this technique is performed and to evaluate preliminary results.

METHODS:

The literature search was performed on online databases in December 2016, without time limits. Studies citing endovascular balloon occlusion of the aorta in trauma were retrieved for evaluation.

RESULTS:

Sixty-one articles met the inclusion criteria and were selected for the systematic review. Overall, they included 1355 treated with aortic endovascular balloon occlusion, and 883 (65%) patients died after the procedure. In most of the included cases, a shock state seemed to be present before the procedure. Time of death and inflation site was not described in the majority of included studies. Procedure-related and shock-related complications are described. Introducer sheath size and comorbidity seems to play the role of risk factors.

CONCLUSIONS:

Resuscitative endovascular balloon occlusion of the aorta is increasingly used in trauma victim resuscitation all over the world, to elevate blood pressure and limit fluid infusion, while other procedures aimed to stop the bleeding are performed. High mortality rate is probably due to the severity of the injuries. Time and place of balloon insertion, zone of balloon inflation, and inflation cutoff time are very heterogeneous.

KEYWORDS:

Aortic balloon occlusion; Bleeding; Hemorrhagic shock; REBOA; Severe trauma; Systematic review; Trauma center; Trauma system

PMID:
28855960
PMCID:
PMC5575940
DOI:
10.1186/s13017-017-0153-2
[Indexed for MEDLINE]
Free PMC Article

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