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https://www.readbyqxmd.com/read/29239852/management-specificities-for-abdominal-pelvic-and-vascular-penetrating-trauma
#1
E Hornez, F Béranger, T Monchal, Y Baudouin, G Boddaert, H De Lesquen, S Bourgouin, Y Goudard, B Malgras, G Pauleau, V Reslinger, N Mocellin, C Natale, L Meyrat, J-P Avaro, P Balandraud, S Gaujoux, S Bonnet
Management of patients with penetrating trauma of the abdomen, pelvis and their surrounding compartments as well as vascular injuries depends on the patient's hemodynamic status. Multiple associated lesions are the rule. Their severity is directly correlated with initial bleeding, the risk of secondary sepsis, and lastly to sequelae. In patients who are hemodynamically unstable, the goal of management is to rapidly obtain hemostasis. This mandates initial laparotomy for abdominal wounds, extra-peritoneal packing (EPP) and resuscitative endovascular balloon occlusion of the aorta (REBOA) in the emergency room for pelvic wounds, insertion of temporary vascular shunts (TVS) for proximal limb injuries, ligation for distal vascular injuries, and control of exteriorized extremity bleeding with a tourniquet, compressive or hemostatic dressings for bleeding at the junction or borderline between two compartments, as appropriate...
November 24, 2017: Journal of Visceral Surgery
https://www.readbyqxmd.com/read/29190256/time-to-aortic-occlusion-it-s-all-about-access
#2
Anna Romagnoli, William Teeter, Jason Pasley, Peter Hu, Melanie Hoehn, Deborah Stein, Thomas Scalea, Megan Brenner
INTRODUCTION: Resuscitative endovascular balloon occlusion of the aorta (REBOA) is a less invasive method of proximal aortic occlusion compared with resuscitative thoracotomy with aortic cross-clamping (RTACC). This study compared time to aortic occlusion with REBOA and RTACC, both including and excluding time required for common femoral artery (CFA) cannulation. METHODS: This was a retrospective, single-institution review of REBOA or RTACC performed between February 2013 and January 2016...
December 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29132575/acute-management-of-the-traumatically-injured-pelvis
#3
REVIEW
Steven Skitch, Paul T Engels
Severe pelvic trauma is a challenging condition. The pelvis can create multifocal hemorrhage that is not easily compressible nor managed by traditional surgical methods such as tying off a blood vessel or removing an organ. Its treatment often requires reapproximation of bony structures, damage control resuscitation, assessment for associated injuries, and triage of investigations, as well as multimodality hemorrhage control (external fixation, preperitoneal packing, angioembolization, REBOA [resuscitative endovascular balloon occlusion of the aorta]) by multidisciplinary trauma specialists (general surgeons, orthopedic surgeons, endovascular surgeons/interventional radiologists)...
February 2018: Emergency Medicine Clinics of North America
https://www.readbyqxmd.com/read/29132574/major-abdominal-trauma-critical-decisions-and-new-frontiers-in-management
#4
REVIEW
Megan Brenner, Christopher Hicks
A standardized approach should be used with a patient with abdominal trauma, including primary and secondary surveys, followed by additional diagnostic testing as indicated. Specific factors can make the diagnosis of serious abdominal trauma challenging, particularly in the face of multiple and severe injuries, unknown mechanism of injury, altered mental status, and impending or complete cardiac arrest. Advances in technology in diagnosis and/or treatment with ultrasound, helical computed tomography, and resuscitative endovascular balloon occlusion of the aorta (REBOA) have significantly advanced trauma care, and are still the focus of current and ongoing investigations...
February 2018: Emergency Medicine Clinics of North America
https://www.readbyqxmd.com/read/29026545/resuscitative-endovascular-balloon-occlusion-of-the-aorta-as-an-adjunct-for-hemorrhagic-shock-due-to-uterine-rupture-a-case-report
#5
Asami Okada, Osamu Nakamoto, Maya Komori, Hideki Arimoto, Hiroshi Rinka, Hiroaki Nakamura
Resuscitative endovascular balloon occlusion of the aorta (REBOA) is a life-saving procedure used to control bleeding and maintain blood pressure temporarily in traumatic hemorrhagic shock. Uterine rupture and placenta accreta provoke uncontrollable massive hemorrhaging. REBOA may be useful for hemodynamic stabilization to prevent cardiac arrest in high-risk pregnancy.
October 2017: Clinical Case Reports
https://www.readbyqxmd.com/read/28991143/the-pitfalls-of-reboa-risk-factors-and-mitigation-strategies
#6
Anders J Davidson, Rachel M Russo, Viktor A Reva, Megan L Brenner, Laura J Moore, Chad Ball, Eileen Bulger, Joseph J DuBose, Ernest E Moore, Todd E Rasmussen
Despite technological advancements, REBOA is associated with significant risks due to complications of vascular access and ischemia-reperfusion. The inherent morbidity and mortality of REBOA is often compounded by coexisting injury and hemorrhagic shock. Additionally, the potential for REBOA-related injuries is exaggerated due to the growing number of interventions being performed by providers who have limited experience in endovascular techniques, inadequate resources, minimal training in the technique, and who are performing this maneuver in emergency situations...
October 4, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28973104/use-of-resuscitative-endovascular-balloon-occlusion-of-the-aorta-for-proximal-aortic-control-in-patients-with-severe-hemorrhage-and-arrest
#7
Megan Brenner, William Teeter, Melanie Hoehn, Jason Pasley, Peter Hu, Shiming Yang, Anna Romagnoli, Jose Diaz, Deborah Stein, Thomas Scalea
Importance: Resuscitative endovascular balloon occlusion of the aorta (REBOA) is a percutaneous transfemoral balloon technique used in select centers for resuscitation and temporary hemostasis, often instead of emergency department thoracotomy. The ability to perform aortic occlusion (AO) with an intravascular device allows focused occlusion at the most distal level to perfuse proximal regions while slowing hemorrhage to injured areas. Objective: To describe what is to date the largest single-institution experience with REBOA in the United States...
September 27, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28958475/successful-use-of-resuscitative-endovascular-balloon-occlusion-of-the-aorta-in-the-treatment-of-ruptured-8-5-cm-splenic-artery-aneurysm
#8
Gabriel Ologun, Keith Sharpton, Paul Granet
Spontaneous rupture of splenic artery aneurysm is a rare cause of acute abdomen with hemorrhagic shock that is a life-threatening surgical emergency. We report a case of a spontaneous rupture of an 8.5-cm splenic artery aneurysm managed using resuscitative endovascular balloon occlusion of the aorta (ER-REBOA Catheter; Prytime Medical Inc, Boerne, Tex) for proximal control of the aorta before laparotomy. This is a minimally invasive technique that can be used as an adjunct to massive transfusion resuscitation and laparotomy for life-threatening intraperitoneal hemorrhage...
December 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28930965/bayesian-clinical-trial-designs-another-option-for-trauma-trials
#9
Jan O Jansen, Philip Pallmann, Graeme MacLennan, Marion K Campbell
Conducting clinical trials in trauma care is challenging. As new treatments become available, we are faced with the dilemma of how to confirm their effectiveness and strengthen the evidence base. Randomized controlled trials are the criterion standard, but target groups in trauma care are often small and specialized, making the classic approach to trial design difficult. Bayesian designs represent an innovative means of increasing trial efficiency and conducting trials with more realistic sample sizes. This article examines the design of such trials, using the UK-REBOA Trial as an example...
October 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28929283/expanding-the-field-of-acute-care-surgery-a-systematic-review-of-the-use-of-resuscitative-endovascular-balloon-occlusion-of-the-aorta-reboa-in-cases-of-morbidly-adherent-placenta
#10
R Manzano-Nunez, M F Escobar-Vidarte, M P Naranjo, F Rodriguez, P Ferrada, J D Casallas, C A Ordoñez
PURPOSE: Prophylactic placement of endovascular balloon occlusion catheters has grown to be part of the surgical plans to control intraoperative hemorrhage in cases of abnormal placentation. We performed a systematic literature review to investigate the safety and effectiveness of the use of REBOA during cesarean delivery in pregnant woman with morbidly adherent placenta. METHODS: A systematic review was performed. Relevant case reports and nonrandomized studies were identified by the literature search in MEDLINE...
September 19, 2017: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/28860179/fewer-reboa-complications-with-smaller-devices-and-partial-occlusion-evidence-from-a-multicentre-registry-in-japan
#11
Yosuke Matsumura, Junichi Matsumoto, Hiroshi Kondo, Koji Idoguchi, Tokiya Ishida, Yuri Kon, Keisuke Tomita, Kenichiro Ishida, Tomoya Hirose, Kensuke Umakoshi, Tomohiro Funabiki
BACKGROUND: Resuscitative endovascular balloon occlusion of the aorta (REBOA) performed by emergency physicians has been gaining acceptance as a less invasive technique than resuscitative thoracotomy. OBJECTIVE: To evaluate access-related complications and duration of occlusions during REBOA. METHODS: Patients with haemorrhagic shock requiring REBOA, from 18 hospitals in Japan, included in the DIRECT-IABO Registry were studied. REBOA-related characteristics were compared between non-survivors and survivors at 24 hours...
December 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/28831501/non-traumatic-hemorrhage-is-controlled-with-reboa-in-acute-phase-then-mortality-increases-gradually-by-non-hemorrhagic-causes-direct-iabo-registry-in-japan
#12
Y Matsumura, J Matsumoto, K Idoguchi, H Kondo, T Ishida, Y Kon, K Tomita, K Ishida, T Hirose, K Umakoshi, T Funabiki
PURPOSE: Resuscitative endovascular balloon occlusion of the aorta (REBOA) is now a feasible and less invasive resuscitation procedure. This study aimed to compare the clinical course of trauma and non-trauma patients undergoing REBOA. METHODS: Patient demographics, etiology, bleeding sites, hemodynamic response, length of critical care, and cause of death were recorded. Characteristics and outcomes were compared between non-trauma and trauma patients. Kaplan-Meier survival analysis was then conducted...
August 22, 2017: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/28817522/a-graphical-guide-to-the-reboa-five-life-saving-steps
#13
Jonathan P Wanderer, Naveen Nathan
No abstract text is available yet for this article.
September 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28801841/the-use-of-aortic-balloon-occlusion-in-traumatic-shock-first-report-from-the-abo-trauma-registry
#14
M Sadeghi, K F Nilsson, T Larzon, A Pirouzram, A Toivola, P Skoog, K Idoguchi, Y Kon, T Ishida, Y Matsumara, J Matsumoto, V Reva, M Maszkowski, A Bersztel, E Caragounis, M Falkenberg, L Handolin, B Kessel, D Hebron, F Coccolini, L Ansaloni, M J Madurska, J J Morrison, T M Hörer
PURPOSE: Resuscitative endovascular balloon occlusion of the aorta (REBOA) is a technique for temporary stabilization of patients with non-compressible torso hemorrhage. This technique has been increasingly used worldwide during the past decade. Despite the good outcomes of translational studies, clinical studies are divided. The aim of this multicenter-international study was to capture REBOA-specific data and outcomes. METHODS: REBOA practicing centers were invited to join this online register, which was established in September 2014...
August 11, 2017: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/28794007/the-future-of-resuscitative-endovascular-balloon-occlusion-in-combat-operations
#15
Shane A Smith, R Hilsden, A Beckett, V C McAlister
Damage control resuscitation and early thoracotomy have been used to increase survival after severe injury in combat. There has been a renewed interest in resuscitative endovascular balloon occlusion of the aorta (REBOA) in both civilian and military medical practices. REBOA may result in visceral and limb ischaemia that could be harmful if use of REBOA is premature or prolonged. The purpose of this paper is to align our experience of combat injuries with the known capability of REBOA to suggest an implementation strategy for the use of REBOA in combat care...
August 9, 2017: Journal of the Royal Army Medical Corps
https://www.readbyqxmd.com/read/28742797/a-comparison-of-selective-aortic-arch-perfusion-and-resuscitative-endovascular-balloon-occlusion-of-the-aorta-for-the-management-of-hemorrhage-induced-traumatic-cardiac-arrest-a-translational-model-in-large-swine
#16
RANDOMIZED CONTROLLED TRIAL
Ed B G Barnard, James E Manning, Jason E Smith, Jason M Rall, Jennifer M Cox, James D Ross
BACKGROUND: Survival rates remain low after hemorrhage-induced traumatic cardiac arrest (TCA). Noncompressible torso hemorrhage (NCTH) is a major cause of potentially survivable trauma death. Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) at the thoracic aorta (Zone 1) can limit subdiaphragmatic blood loss and allow for IV fluid resuscitation when intrinsic cardiac activity is still present. Selective Aortic Arch Perfusion (SAAP) combines thoracic aortic balloon hemorrhage control with intra-aortic oxygenated perfusion to achieve return of spontaneous circulation (ROSC) when cardiac arrest has occurred...
July 2017: PLoS Medicine
https://www.readbyqxmd.com/read/28738933/repeatability-of-reboa-as-an-unforeseen-tool
#17
Joseph A Ibrahim, Karen Safcsak, Howard G Smith
No abstract text is available yet for this article.
July 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28725258/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
#18
REVIEW
Ramiro Manzano Nunez, Maria Paula Naranjo, Esteban Foianini, Paula Ferrada, Erika Rincon, Herney Andrés García-Perdomo, Paola Burbano, Juan Pablo Herrera, Alberto F García, Carlos A Ordoñez
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...
2017: World Journal of Emergency Surgery: WJES
https://www.readbyqxmd.com/read/28723841/military-civilian-partnership-in-device-innovation-development-commercialization-and-application-of-resuscitative-endovascular-balloon-occlusion-of-the-aorta-reboa
#19
Todd E Rasmussen, Jonathan L Eliason
Noncompressible torso hemorrhage (NCTH) and shock is a leading cause of trauma-related mortality and evidence suggests that survival from this injury pattern has not improved in decades. As such, innovating new approaches and devices, including technologies which can be used by providers within a short of time after severe injury, is a priority for the military. Guided by wartime observations, and through partnerships with civilian academia and private investment, the military has led an effort to define resuscitative endovascular balloon occlusion of the aorta (REBOA) and assess its potential to address this problem...
July 19, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28716775/acute-rehabilitation-after-resuscitative-endovascular-balloon-occlusion-of-the-aorta-reboa-in-major-trauma
#20
Jessica Anne Rich, Julia Coleman, Camille Devaux, Karen Hoffman
We report a 23-year-old woman admitted post cyclist versus heavy goods vehicle accident in December 2014. This was the second case the life-saving procedure, that is, resuscitative endovascular balloon occlusion of the aorta (REBOA) was performed on at the roadside. This advanced procedure was performed due to the extensive haemorrhage from this patient's complex pelvic fracture . As a result of REBOA, the patient consequently lost her left lower limb and underwent a variety of complex pelvic and lower limb surgeries...
July 17, 2017: BMJ Case Reports
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