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Am J Surg. 2019 Apr 27. pii: S0002-9610(18)31492-2. doi: 10.1016/j.amjsurg.2019.04.019. [Epub ahead of print]

Catheter distances and balloon inflation volumes for the ER-REBOA™ catheter: A prospective analysis.

Author information

1
University of Texas Health Sciences Center and the McGovern School of Medicine, Houston, TX, USA. Electronic address: david.e.meyer@uth.tmc.edu.
2
University of Texas Health Sciences Center and the McGovern School of Medicine, Houston, TX, USA. Electronic address: megan.t.mont@uth.tmc.edu.
3
University of Texas Health Sciences Center and the McGovern School of Medicine, Houston, TX, USA. Electronic address: john.a.harvin@uth.tmc.edu.
4
University of Texas Health Sciences Center and the McGovern School of Medicine, Houston, TX, USA. Electronic address: lillian.s.kao@uth.tmc.edu.
5
University of Texas Health Sciences Center, The McGovern School of Medicine, The Center for Translational Injury Research, Houston, TX, USA. Electronic address: charles.e.wade@uth.tmc.edu.
6
University of Texas Health Sciences Center and the McGovern School of Medicine, Houston, TX, USA. Electronic address: laura.j.moore@uth.tmc.edu.

Abstract

INTRODUCTION:

Resuscitative endovascular balloon occlusion of the aorta (REBOA) is an adjunct used to temporize uncontrolled abdominopelvic hemorrhage. No published clinical data exist that describe average catheter lengths or balloon fill volumes necessary to occlude the aorta.

METHODS:

A prospective, single-institution registry was queried for patients who underwent placement of a Prytime ER-REBOA™ catheter. Demographic, catheter, hemodynamic, and morphometric data were measured. Linear regression analyses were performed to identify variables associated with insertion distances and balloon volumes.

RESULTS:

45 patients underwent supraceliac REBOA: median catheter insertion distance 45 cm [IQR 42-46], balloon inflation volume 14 mL [IQR 8-19], systolic blood pressure (SBP) augmentation 50 mmHg [IQR 35-55]. 14 patients underwent infrarenal deployment: median catheter insertion distance 28.5 cm [IQR 26.5-32.5], balloon volume 10 mL [IQR 5-15]; SBP augmentation 55 mmHg [IQR 40-65]. Patient body metrics were not associated with catheter length or balloon volume.

CONCLUSION:

A wide range of catheter insertion distances and balloon fill volumes were necessary for correct REBOA positioning and occlusion. No single patient metric accurately correlated with catheter distance or balloon volume.

LEVEL OF EVIDENCE:

Level IV, Prognostic.

KEYWORDS:

Aorta; Distance; Non-compressible torso hemorrhage; Prytime; REBOA; Volume

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