Endovascular Resuscitation with Aortic Balloon Occlusion in pediatric trauma

Abstract

Background The use of Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) in resuscitation and trauma management in adults is increasing. However, there is limited data published concerning its use in pediatric patients. Methods We describe a case using REBOA for traumatic hemorrhagic shock in a pediatric patient according to the concept of EndoVascular resuscitation and Trauma Management (EVTM) at Örebro University Hospital in April 2019. Informed consent has been received. Results  An 11-year-old boy arrived to the emergency room (ER) after a motor vehicle accident. Due to total hemodynamic collapse, cardiopulmonary resuscitation was initiated with return of spontaneous circulation. Zone 1 total REBOA was successfully performed for 7 minutes while damage control surgery was performed and massive transfusion was initiated to stabilize the patient. The patient survived and returned to almost normal daily activity. Conclusion REBOA for endovascular resuscitation and trauma management may be an additional method for temporary hemodynamic stabilization in pediatric patients and, in this specific patient, was used instead of resuscitative thoracotomy.   Keywords: REBOA; Hemorrhage; Hemorrhagic Shock; Endovascular Resuscitation, Pediatric Trauma