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Resuscitative Endovascular Occlusion of the Aorta

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https://www.readbyqxmd.com/read/28459798/resuscitative-endovascular-balloon-occlusion-of-the-aorta-reboa-for-major-abdominal-venous-injury-in-a-porcine-hemorrhagic-shock-model
#1
Michael S Lallemand, Donald M Moe, John M McClellan, Joshua P Smith, Leo Daab, Shannon Marko, Nam Tran, Benjamin Starnes, Matthew J Martin
BACKGROUND: Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) is a rescue maneuver for unstable patients with non-compressible hemorrhage below the diaphragm. The efficacy of REBOA in the setting a major abdominal venous injury is unknown. Our objective was to examine the use of REBOA in a large animal model of major abdominal venous injury, and characterize any impact on the hemodynamics, rate and volume of hemorrhage, and survival. METHODS: Ten swine (35-55kg) underwent a controlled and validated hemorrhage and ischemia/reperfusion injury protocol to produce shock physiology...
April 28, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28452882/field-and-en-route-reboa-a-feasible-military-reality
#2
Viktor A Reva, Tal Hörer, Andrey I Makhnovskiy, Mikhail V Sokhranov, Igor M Samokhvalov, Joseph J DuBose
BACKGROUND: Severe non-compressible torso hemorrhage (NCTH) remains a leading cause of potentially preventable death in modern military conflicts. Resuscitative endovascular occlusion of the aorta (REBOA) has demonstrated potential as an effective adjunct to the treatment of NCTH in the civilian early hospital and even pre-hospital settings - but the application of this technology for military pre-hospital use has not been well described. We aimed to assess the feasibility of both field and en route pre-hospital REBOA in the military exercise setting simulating a modern armed conflict...
April 27, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28430760/resuscitative-endovascular-balloon-occlusion-of-the-aorta-or-resuscitative-thoracotomy-with-aortic-clamping-for-noncompressible-torso-hemorrhage-a-retrospective-nationwide-study
#3
Shotaro Aso, Hiroki Matsui, Kiyohide Fushimi, Hideo Yasunaga
BACKGROUND: Resuscitative endovascular balloon occlusion of the aorta (REBOA) is an emerging treatment for noncompressible torso hemorrhage. It remains unclear if REBOA is superior to resuscitative thoracotomy with aortic cross-clamping (RT) in terms of improving outcomes. This study compared in-hospital outcomes between REBOA and RT in trauma patients with uncontrolled hemorrhagic shock, using data from a national inpatient database in Japan. METHODS: Using the Diagnosis Procedure Combination database, we identified patients who received REBOA or RT within 1 day after admission from July 1, 2010, to March 31, 2014...
May 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28424126/the-novel-use-of-resuscitative-endovascular-balloon-occlusion-of-the-aorta-to-explore-a-retroperitoneal-hematoma-in-a-hemodynamically-unstable-patient
#4
Martin D Rosenthal, Ahsan Raza, Stephanie Markle, Chasen A Croft, Alicia M Mohr, R Stephen Smith
Balloon occlusion of the aorta was first described by C.W. Hughes in 1954, when it was used as a tamponade device for three wounded soldiers during the Korean War suffering from intra-abdominal hemorrhage. Currently, the device is indicated in trauma patients as a surrogate for resuscitative thoracotomy. Brenner et al. reported a case series describing the use of resuscitative endovascular balloon occlusion of the aorta (REBOA) in advanced hemorrhagic shock. Their conclusion was that "it is a feasible method for proximal aortic control...
April 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28422912/vascular-complications-from-resuscitative-endovascular-balloon-occlusion-of-the-aorta-reboa-life-over-limb
#5
John R Taylor, John A Harvin, Clay Martin, John B Holcomb, Laura J Moore
BACKGROUND: Vascular complications from resuscitative endovascular balloon occlusion of the aorta (REBOA) have been reported as high as 13% with some patients requiring lower extremity amputation. We sought to review our institutions series of REBOA and assess our vascular complications. METHODS: Retrospective review of all patients undergoing REBOA from October 2011 through July 2016. Data was gathered from the Memorial Hermann Trauma registry and the hospital electronic medical records...
April 18, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28422910/incremental-balloon-deflation-following-complete-reboa-results-in-steep-inflection-of-flow-and-rapid-reperfusion-in-a-large-animal-model-of-hemorrhagic-shock
#6
Anders J Davidson, Rachel M Russo, Sarah-Ashley E Ferencz, Jeremy W Cannon, Todd E Rasmussen, Lucas P Neff, M Austin Johnson, Timothy K Williams
INTRODUCTION: To avoid potential cardiovascular collapse after Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA), current guidelines recommend methodically deflating the balloon over 5 minutes to gradually reperfuse distal tissue beds. However, anecdotal evidence suggests that this approach may still result in unpredictable aortic flow rates and hemodynamic instability. We sought to characterize aortic flow dynamics following REBOA as the balloon is deflated in accordance with current practice guidelines...
April 18, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28379869/resuscitative-endovascular-balloon-occlusion-of-the-aorta-and-the-anesthesiologist-a-case-report-and-literature-review
#7
Bianca M Conti, Justin E Richards, Rishi Kundi, Jason Nascone, Thomas M Scalea, Maureen McCunn
The most common preventable cause of death after trauma is exsanguination due to uncontrolled hemorrhage. Traditionally, anterolateral emergency department thoracotomy is used for temporary control of noncompressible torso hemorrhage and to increase preload after trauma. Resuscitative endovascular balloon occlusion of the aorta is a minimally invasive technique that achieves similar goals. It is therefore imperative for the anesthesiologist to understand physiologic implications during resuscitative endovascular aortic occlusion and after balloon deflation...
April 4, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28376018/how-i-do-it-partial-resuscitative-endovascular-balloon-occlusion-of-the-aorta-p-reboa
#8
Joseph J DuBose
No abstract text is available yet for this article.
April 4, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28355242/fluoroscopy-free-resuscitative-endovascular-balloon-occlusion-of-the-aorta-reboa-for-controlling-life-threatening-postpartum-hemorrhage
#9
Knut Haakon Stensaeth, Edmund Sovik, Ingrid Natasha Ylva Haig, Erna Skomedal, Arve Jorgensen
BACKGROUND: Severe postpartum hemorrhage occurs in 1/1000 women giving birth. This condition is often dramatic and may be life threatening. Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) has in recent years been introduced as a novel treatment for hemorrhagic shock. We present a series of fluoroscopy-free REBOA for controlling life threatening postpartum hemorrhage. METHODS: In 2008 an 'aortic occlusion kit' was assembled and used in three Norwegian university hospitals...
2017: PloS One
https://www.readbyqxmd.com/read/28340927/resuscitative-endovascular-balloon-occlusion-of-the-aorta-for-control-of-noncompressible-truncal-hemorrhage-in-the-abdomen-and-pelvis
#10
Laura J Moore, Clay D Martin, John A Harvin, Charles E Wade, John B Holcomb
BACKGROUND: Noncompressible truncal hemorrhage is a leading cause of potentially preventable death in trauma and acute care surgery patients. These patients are at high risk of exsanguination before potentially life-saving surgical intervention may be performed. Temporary aortic occlusion is an effective means of augmenting systolic blood pressure and perfusion of the heart and brain in these patients. Aortic occlusion temporarily controls distal bleeding until permanent hemostasis can be achieved...
December 2016: American Journal of Surgery
https://www.readbyqxmd.com/read/28338590/small-changes-big-effects-the-hemodynamics-of-partial-and-complete-aortic-occlusion-to-inform-next-generation-resuscitation-techniques-and-technologies
#11
M Austin Johnson, Anders J Davidson, Rachel M Russo, Sarah-Ashley E Ferencz, Oren Gotlib, Todd E Rasmussen, Lucas P Neff, Timothy K Williams
BACKGROUND: The transition from complete aortic occlusion during resuscitative endovascular balloon occlusion of the aorta can be associated with hemodynamic instability. Technique refinements and new technologies have been proposed to minimize this effect. In order to inform new techniques and technology, we examined the relationship between blood pressure and aortic flow during the restoration of systemic circulation following aortic occlusion at progressive levels of hemorrhage. METHODS: An automated supraceliac aortic clamp, capable of continuously variable degrees of occlusion, was applied in seven swine...
June 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28328730/partial-occlusion-conversion-from-thoracotomy-undelayed-but-shorter-occlusion-resuscitative-endovascular-balloon-occlusion-of-the-aorta-strategy-in-japan
#12
Yosuke Matsumura, Junichi Matsumoto, Hiroshi Kondo, Koji Idoguchi, Tomohiro Funabiki
INTRODUCTION: Resuscitative endovascular balloon occlusion of the aorta (REBOA) is a viable alternative to resuscitative thoracotomy (RT) in refractory hemorrhagic patients. We evaluated REBOA strategies using Japanese multi-institutional data. PATIENTS AND METHODS: The DIRECT-IABO investigators registered trauma patients requiring REBOA from 18 hospitals. Patients' characteristics, outcomes, and time in initial treatment were collected and analyzed. RESULTS: From August 2011 to December 2015, 106 trauma patients were analyzed...
March 21, 2017: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
https://www.readbyqxmd.com/read/28285483/a-perspective-on-the-potential-for-battlefield-resuscitative-endovascular-balloon-occlusion-of-the-aorta
#13
Ryan M Knight
Resuscitative endovascular balloon occlusion of the aorta (REBOA) has a place in civilian trauma centers in the United States, and British physicians performed the first prehospital REBOA, proving the concept viable for civilian emergency medical service. Can this translate into battlefield REBOA to stop junctional hemorrhage and extend "golden hour" rings in combat? If yes, at what level is this procedure best suited and what does it entail? This author's perspective, after treating patients on the battlefield and during rotary wing evacuation, is that REBOA may have a place in prehospital resuscitation but patient and provider selection are paramount...
2017: Journal of Special Operations Medicine: a Peer Reviewed Journal for SOF Medical Professionals
https://www.readbyqxmd.com/read/28285476/resuscitative-endovascular-balloon-occlusion-of-the-aorta-pushing-care-forward
#14
William Teeter, Anna Romagnoli, Jacob Glaser, Andrew D Fisher, Jason Pasley, Brian Scheele, Melanie Hoehn, Megan Brenner
BACKGROUND: Resuscitative endovascular balloon occlusion of the aorta (REBOA), used to temporize noncompressible and junctional hemorrhage, may be deployable to the forward environment. Our hypothesis was that nonsurgeon physicians and high-level military medical technicians would be able to learn the theory and insertion of REBOA. METHODS: US Army Special Operations Command medical personnel without prior endovascular experience were included. All participants received didactic instruction of the Basic Endovascular Skills for Trauma Course™ together, with individual evaluation of technical skills...
2017: Journal of Special Operations Medicine: a Peer Reviewed Journal for SOF Medical Professionals
https://www.readbyqxmd.com/read/28285473/a-modern-case-series-of-resuscitative-endovascular-balloon-occlusion-of-the-aorta-reboa-in-an-out-of-hospital-combat-casualty-care-setting
#15
Justin D Manley, Benjamin J Mitchell, Joseph J DuBose, Todd E Rasmussen
BACKGROUND: Resuscitative endovascular balloon occlusion of the aorta (REBOA) is used to mitigate bleeding and sustain central aortic pressure in the setting of shock. The ER-REBOA™ catheter is a new REBOA technology, previously reported only in the setting of civilian trauma and injury care. The use of REBOA in an out-of-hospital setting has not been reported, to our knowledge. METHODS: We present a case series of wartime injured patients cared for by a US Air Force Special Operations Surgical Team at an austere location fewer than 3km (5-10 minutes' transport) from point of injury and 2 hours from the next highest environment of care-a Role 2 equivalent...
2017: Journal of Special Operations Medicine: a Peer Reviewed Journal for SOF Medical Professionals
https://www.readbyqxmd.com/read/28222758/erratum-to-resuscitative-endovascular-balloon-occlusion-of-the-aorta-versus-aortic-cross-clamping-among-patients-with-critical-trauma-a-nationwide-cohort-study-in-japan
#16
Toshikazu Abe, Masatoshi Uchida, Isao Nagata, Daizoh Saitoh, Nanako Tamiya
No abstract text is available yet for this article.
February 22, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28215930/ultrasound-guided-resuscitative-endovascular-balloon-occlusion-of-the-aorta-in-the-resuscitation-area
#17
Takayuki Ogura, Alan Kawarai Lefor, Mitsunobu Nakamura, Kenji Fujizuka, Kousuke Shiroto, Minoru Nakano
BACKGROUND: In trauma resuscitation with resuscitative endovascular balloon occlusion of the aorta (REBOA), urgent and accurate placement of the catheter in the resuscitation area without fluoroscopy can shorten the time from admission to REBOA, allowing rapid, temporary control of bleeding. DISCUSSION: The experience-based protocol in our center for ultrasound-guided REBOA in the resuscitation area without fluoroscopy is as follows: the femoral artery is punctured and a guidewire inserted; sonography is used to verify that the guidewire is in the abdominal aorta; the position of the balloon is confirmed with ultrasound after estimating the distance to the clavicle, and the pressure in the radial artery and sheath is used to monitor correct positioning; connect the pressure transducer to the catheter sheath for continuous monitoring of the blood pressure in the sheath, and inflate the balloon until the blood pressure tracing at the sheath has disappeared; check the pulse in the left radial artery, and withdraw the catheter slightly if the pulse in the radial artery is not palpable or is decreased (if this pulse is not palpable or decreased, the balloon is in the aortic arch)...
May 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28166165/automated-variable-aortic-control-versus-complete-aortic-occlusion-in-a-swine-model-of-hemorrhage
#18
Timothy K Williams, Lucas P Neff, Michael Austin Johnson, Rachel M Russo, Sarah-Ashley Ferencz, Anders J Davidson, Nathan F Clement, John Kevin Grayson, Todd E Rasmussen
BACKGROUND: Future endovascular hemorrhage control devices will require features that mitigate the adverse effects of vessel occlusion. Permissive regional hypoperfusion (PRH) with variable aortic control (VAC) is a novel strategy to minimize hemorrhage and reduce the ischemic burden of complete aortic occlusion (AO). The objective of this study was to compare PRH with VAC to AO in a lethal model of hemorrhage. METHODS: Twenty-five swine underwent cannulation of the supraceliac aorta, with diversion of aortic flow through an automated extracorporeal circuit...
April 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28117180/the-role-of-resuscitative-endovascular-balloon-occlusion-of-the-aorta-reboa-as-an-adjunct-to-acls-in-non-traumatic-cardiac-arrest-a-review-of-key-concepts-physiology-current-evidence-and-future-directions
#19
James Daley, Jonathan James Morrison, John Sather, Lisa Hile
Non-traumatic cardiac arrest is a major public health problem that carries an extremely high mortality rate. If we hope to increase the survivability of this condition, it is imperative that alternative methods of treatment are given due consideration. Balloon occlusion of the aorta can be used as a method of circulatory support in the critically ill patient. Intra-aortic balloon pumps have been used to temporize patients in cardiogenic shock for decades. More recently, resuscitative endovascular balloon occlusion of the aorta (REBOA) has been utilized in the patient in hemorrhagic shock or cardiac arrest secondary to trauma...
January 12, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28030495/resuscitative-endovascular-balloon-occlusion-of-the-aorta-in-trauma-patients-in-youth
#20
Tatsuya Norii, Shin Miyata, Yusuke Terasaka, Sundeep Guliani, Stephen W Lu, Cameron Crandall
BACKGROUND: Resuscitative endovascular balloon occlusion of the aorta (REBOA) has received increasing attention for critically uncontrolled hemorrhagic shock. However, the efficacy of REBOA in patients in youth is unknown. OBJECTIVES: The aim of this study was to evaluate the mortality and characteristics of patients of age ≤18 years with severe traumatic injury who received REBOA. METHODS: We retrospectively analyzed observational cohort data from the Japan Trauma Data Bank (JTDB) from 2004 to 2015...
May 2017: Journal of Trauma and Acute Care Surgery
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