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Military REBOA

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https://www.readbyqxmd.com/read/28794007/the-future-of-resuscitative-endovascular-balloon-occlusion-in-combat-operations
#1
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/28723841/military-civilian-partnership-in-device-innovation-development-commercialization-and-application-of-resuscitative-endovascular-balloon-occlusion-of-the-aorta-reboa
#2
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/28628603/field-and-en-route-resuscitative-endovascular-occlusion-of-the-aorta-a-feasible-military-reality
#3
Viktor A Reva, Tal M Hörer, Andrey I Makhnovskiy, Mikhail V Sokhranov, Igor M Samokhvalov, Joseph J DuBose
BACKGROUND: Severe noncompressible torso hemorrhage 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 noncompressible torso hemorrhage in the civilian early hospital and even prehospital settings-but the application of this technology for military prehospital use has not been well described. We aimed to assess the feasibility of both field and en route prehospital REBOA in the military exercise setting, simulating a modern armed conflict...
July 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28452882/field-and-en-route-reboa-a-feasible-military-reality
#4
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/28285476/resuscitative-endovascular-balloon-occlusion-of-the-aorta-pushing-care-forward
#5
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...
December 0: Journal of Special Operations Medicine: a Peer Reviewed Journal for SOF Medical Professionals
https://www.readbyqxmd.com/read/27973670/fixed-distance-model-for-balloon-placement-during-fluoroscopy-free-resuscitative-endovascular-balloon-occlusion-of-the-aorta-in-a-civilian-population
#6
Pierre Pezy, Alexandros N Flaris, Nicolas J Prat, François Cotton, Peter W Lundberg, Jean-Louis Caillot, Jean-Stéphane David, Eric J Voiglio
Importance: Resuscitative endovascular balloon occlusion of the aorta (REBOA) is an innovative procedure in the treatment of noncompressible truncal hemorrhage. However, readily available fluoroscopy remains a limiting factor in its widespread implementation. Several methods have been proposed to perform REBOA without fluoroscopic guidance, and these methods were adapted predominantly from the military theater. Objective: To develop a method for performing REBOA in a civilian population using a standardized distance from a set point of entry...
April 1, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/27623805/prehospital-control-of-life-threatening-truncal-and-junctional-haemorrhage-is%C3%A2-the-ultimate-challenge-in-optimizing-trauma-care-a-review-of-treatment-options-and-their-applicability-in-the-civilian-trauma-setting
#7
REVIEW
S E van Oostendorp, E C T H Tan, L M G Geeraedts
INTRODUCTION: Exsanguination following trauma is potentially preventable. Extremity tourniquets have been successfully implemented in military and civilian prehospital care. Prehospital control of bleeding from the torso and junctional area's remains challenging but offers a great potential to improve survival rates. This review aims to provide an overview of potential treatment options in both clinical as preclinical state of research on truncal and junctional bleeding. Since many options have been developed for application in the military primarily, translation to the civilian situation is discussed...
September 13, 2016: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/25909430/the-role-of-reboa-in-the-control-of-exsanguinating-torso-hemorrhage
#8
REVIEW
Walter L Biffl, Charles J Fox, Ernest E Moore
The management of patients with exsanguinating torso hemorrhage is challenging. Emergency surgery, with the occasional use of resuscitative thoracotomy for patient in extremis, is the current standard. Recent reports of REBOA (resuscitative endovascular balloon occlusion of the aorta) have led to discussions about changing paradigms in the management of patients in both civilian and military are nas. We submit that broad and liberal application of this technique is premature given the current data and in light of historical experience...
May 2015: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/25449984/functional-outcome-after-resuscitative-endovascular-balloon-occlusion-of-the-aorta-of-the-proximal-and-distal-thoracic-aorta-in-a-swine-model-of-controlled-hemorrhage
#9
COMPARATIVE STUDY
Kira N Long, Robert Houston, J Devin B Watson, Jonathan J Morrison, Todd E Rasmussen, Brandon W Propper, Zachary M Arthurs
BACKGROUND: Noncompressible torso hemorrhage remains an ongoing problem for both military and civilian trauma. Resuscitative endovascular balloon occlusion of the aorta (REBOA) has been characterized as a potentially life-saving maneuver. The objective of this study was to determine the functional outcomes, paraplegia rates, and survival of 60-min balloon occlusion in the proximal and distal thoracic aorta in a porcine model of controlled hemorrhage. METHODS: Swine (Sus scrofa, 70-110 kg) were subjected to class IV hemorrhagic shock and underwent 60 min of REBOA...
January 2015: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/25133599/resuscitative-endovascular-balloon-occlusion-of-the-aorta-a-gap-analysis-of-severely-injured-uk-combat-casualties
#10
Jonathan J Morrison, James D Ross, Todd E Rasmussen, Mark J Midwinter, Jan O Jansen
The control of torso and junctional zone bleeding in combat casualties is particularly challenging because of its noncompressible nature. Resuscitative endovascular balloon occlusion of the aorta (REBOA) has demonstrated promise in translational large animal and early clinical series as an effective resuscitation and hemorrhage control adjunct. However, it is unknown what proportion of combat casualties has an injury pattern and clinical course that is amenable to REBOA deployment. The prospective UK Joint Theatre Trauma Registry was used to retrospectively identify all UK military personnel who has sustained a severe combat injury, defined as an Abbreviated Injury Scale of three or greater, in the course of 10 years...
May 2014: Shock
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