Resuscitative endovascular balloon occlusion of the aorta (REBOA) for temporization of hemorrhage in adolescent trauma patients
| Autor: | Alexis D. Smith, Megan Brenner, Laura J. Moore, Jessica A. Hudson, Thomas M. Scalea |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Resuscitation
medicine.medical_specialty Adolescent Aorta Thoracic Shock Hemorrhagic Return of spontaneous circulation Traumatic Hemorrhage 03 medical and health sciences 0302 clinical medicine Blunt 030225 pediatrics medicine.artery medicine Humans Thoracic aorta Aorta Abdominal Hospital Mortality Aorta business.industry Endovascular Procedures Abdominal aorta General Medicine Balloon Occlusion medicine.disease Surgery 030220 oncology & carcinogenesis Pediatrics Perinatology and Child Health Wounds and Injuries Return of Spontaneous Circulation business Pediatric trauma |
| Zdroj: | Journal of Pediatric Surgery. 55:2732-2735 |
| ISSN: | 0022-3468 |
| DOI: | 10.1016/j.jpedsurg.2020.08.007 |
| Popis: | Background/purpose Resuscitative endovascular balloon occlusion of the aorta (REBOA) has emerged as an alternative technique for traumatic hemorrhage control in the adult population. The purpose of this study is to describe the details of REBOA placement in adolescent trauma patients. Methods Patients 18 years of age or less who received REBOA for aortic occlusion (AO) from August 2013 to February 2017 at 2 urban tertiary care centers were included. Results 7 adolescent trauma patients received REBOA by trauma surgeons for both blunt (n = 4) and penetrating mechanisms (n = 3); mean age was 17 + 1.5 years, mean admission lactate 13.0 + 4.85 mmol/L, and mean Hgb 10.7 + 2.7 g/dL. 3 patients received REBOA through a 12Fr sheath and 4 through a 7Fr sheath. AO occurred mostly at the distal thoracic aorta (Zone I) (85.7%) and also in the distal abdominal aorta (Zone III) (14.3%). 57% of patients were in arrest with ongoing CPR at the time of REBOA. In-hospital mortality was 57%; all of these patients were in arrest at the time of REBOA, had return of spontaneous circulation (ROSC), and survived to the operating room. No complications from REBOA were identified. Conclusion REBOA appears to be feasible for use in adolescents despite their smaller caliber vessels, even with use of a 12Fr sheath. REBOA results in improved physiology and can bridge adolescent trauma patients presenting in extremis to the operating room. Type of study Treatment/therapeutic study Level of evidence Level IV. |
| Databáze: | OpenAIRE |
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