REBOA in trauma: a life-saving intervention or a spectacular failure?

IF 1.9 3区医学 Q2 EMERGENCY MEDICINE

European Journal of Trauma and Emergency Surgery Pub Date : 2024-09-09 DOI:10.1007/s00068-024-02657-x

Bellal Joseph, Demetrios Demetriades

{"title":"REBOA in trauma: a life-saving intervention or a spectacular failure?","authors":"Bellal Joseph, Demetrios Demetriades","doi":"10.1007/s00068-024-02657-x","DOIUrl":null,"url":null,"abstract":"Purpose: Resuscitative endovascular balloon occlusion of the aorta (REBOA) is a controversial haemorrhage control intervention often touted as the bridge to definitive haemorrhage control. This review summarizes the evolution of REBOA from its inception to the latest applications with an emphasis on clinical outcomes.Methods: This is a narrative review based on a selective review of the literature.Results: REBOA remains a rarely utilized intervention in trauma patients. Complications have remained consistent over time despite purported improvements in catheter technology. Ischemia-reperfusion injuries, end-organ dysfunction, limb ischemia, and amputations have all been reported. Evidence-based guidelines are lacking, and appropriate indications and the ideal patient population for this intervention are yet to be defined.Conclusion: Despite the hype, purported technological advancements, and the mirage of high-quality studies over the last decade, REBOA has failed to keep up to its expectations. The quest to find the solution for uncontrolled NCTH remains unsolved.","PeriodicalId":12064,"journal":{"name":"European Journal of Trauma and Emergency Surgery","volume":null,"pages":null},"PeriodicalIF":1.9000,"publicationDate":"2024-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"European Journal of Trauma and Emergency Surgery","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s00068-024-02657-x","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"EMERGENCY MEDICINE","Score":null,"Total":0}

引用次数: 0

Abstract

Purpose: Resuscitative endovascular balloon occlusion of the aorta (REBOA) is a controversial haemorrhage control intervention often touted as the bridge to definitive haemorrhage control. This review summarizes the evolution of REBOA from its inception to the latest applications with an emphasis on clinical outcomes.

Methods: This is a narrative review based on a selective review of the literature.

Results: REBOA remains a rarely utilized intervention in trauma patients. Complications have remained consistent over time despite purported improvements in catheter technology. Ischemia-reperfusion injuries, end-organ dysfunction, limb ischemia, and amputations have all been reported. Evidence-based guidelines are lacking, and appropriate indications and the ideal patient population for this intervention are yet to be defined.

Conclusion: Despite the hype, purported technological advancements, and the mirage of high-quality studies over the last decade, REBOA has failed to keep up to its expectations. The quest to find the solution for uncontrolled NCTH remains unsolved.

查看原文本刊更多论文

创伤中的 REBOA：是挽救生命的干预措施还是令人瞩目的失败？

目的：主动脉血管内球囊闭塞复苏术（REBOA）是一种备受争议的出血控制干预措施，经常被吹捧为通向明确出血控制的桥梁。本综述总结了REBOA从诞生到最新应用的演变过程，重点关注临床结果：方法：这是一篇基于文献选择性回顾的叙述性综述：结果：REBOA在创伤患者中仍然很少使用。尽管导管技术据称有所改进，但并发症仍长期存在。缺血再灌注损伤、内脏器官功能障碍、肢体缺血和截肢均有报道。目前还缺乏循证指南，这种干预的适当适应症和理想的患者人群也尚未确定：尽管在过去十年中，REBOA 被炒得沸沸扬扬，号称技术进步，高质量的研究也如海市蜃楼般层出不穷，但它并没有达到预期的效果。为不受控制的 NCTH 寻找解决方案的任务仍未完成。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

European Journal of Trauma and Emergency Surgery 医学-急救医学

CiteScore

4.50

自引率

14.30%

发文量

311

审稿时长

3 months

期刊介绍： The European Journal of Trauma and Emergency Surgery aims to open an interdisciplinary forum that allows for the scientific exchange between basic and clinical science related to pathophysiology, diagnostics and treatment of traumatized patients. The journal covers all aspects of clinical management, operative treatment and related research of traumatic injuries. Clinical and experimental papers on issues relevant for the improvement of trauma care are published. Reviews, original articles, short communications and letters allow the appropriate presentation of major and minor topics.