Feasibility study for implementation of resuscitative balloon occlusion of the aorta in peri‐arrest, exsanguinating trauma at an adult level 1 Australian trauma centre
| Autor: | Biswadev Mitra, Simon Hendel, Louise E. Niggemeyer, Joseph Mathew, Meei Yeung, Robbie Lendrum, Stephen Bernard, Christopher P Nickson, De Villiers Smit, Mark Fitzgerald, Richard M-H Lin, Adam Bystrzycki, Yesul Kim, John Moloney |
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| Rok vydání: | 2019 |
| Předmět: |
Adult
Male medicine.medical_specialty Adolescent Victoria Resuscitation Peri Vital signs Hemorrhage 03 medical and health sciences 0302 clinical medicine Trauma Centers medicine.artery medicine Humans Prospective Studies 030212 general & internal medicine Prospective cohort study Aorta business.industry Major trauma Shock 030208 emergency & critical care medicine Balloon Occlusion Middle Aged medicine.disease Survival Rate Balloon occlusion Shock (circulatory) Emergency medicine Emergency Medicine Feasibility Studies Female Observational study medicine.symptom business Algorithms Out-of-Hospital Cardiac Arrest |
| Zdroj: | Emergency Medicine Australasia. 32:127-134 |
| ISSN: | 1742-6723 1742-6731 |
| DOI: | 10.1111/1742-6723.13443 |
| Popis: | This prospective, observational, interventional study sought to determine if the introduction of resuscitative balloon occlusion of the aorta (REBOA) at an Australian adult major trauma centre would improve survival for major trauma patients.Patients aged 18-60 years, transported directly from scene with exsanguinating, sub-diaphragmatic haemorrhage and hypovolaemic shock (systolic BP70 mmHg or hypovolaemic cardiac arrest) were eligible for recruitment and followed up until hospital discharge (ACTRN12618000550202).During the 14-month study period (17 January 2015 to 12 March 2016) 3032 patients were admitted direct from scene with an overall mortality of 97 (3.71%). Of these patients 3019 had trauma centre vital signs recorded in the data set (99.57%) and 1523 were between the ages of 18-60, including 143 patients with a shock index of1.0 (4.74%). There were 13 (0.43%) patients with a systolic BP70 mmHg and/or cardiorespiratory arrest on arrival. The mortality in this group was six out of 13 (46.15%). Of these 13 patients, there were two (0.07% of the total cohort) where REBOA was attempted. There were no eligible patients for whom REBOA was achieved. None of the six patients who died would have benefited from REBOA deployment.Despite considerable training and resource allocation to ensure 24-h availability, the introduction of REBOA failed to effectively demonstrate any impact on patient outcome. Despite retrospective literature supporting the introduction of REBOA, in this 14-month prospective study there was no evidence of benefit. Further studies may define indications and subgroups of patients who may benefit. |
| Databáze: | OpenAIRE |
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