Place the Sheath: Emergent 7 French Femoral Sheath Placement is Low Risk During Initial Trauma Resuscitation

IF 0.2 Q4 EMERGENCY MEDICINE

Journal of EndoVascular Resuscitation and Trauma Management Pub Date : 2023-01-20 DOI:10.26676/jevtm.269

Alexis L. Cralley, M. Debot, Jamie Hadley, F. Pieracci, Barry Platnick, Eric Campioin, Ernest E. Moore, Mitchell J Cohen, C. Fox, R. Lawless

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引用次数: 0

Abstract

Background: We hypothesized that emergent placement of 7 French (Fr) common femoral artery (CFA) sheathsduring trauma resuscitation for potential resuscitative endovascular balloon occlusion of the aorta (REBOA) carries alow complication rate.Methods: Trauma patients at a Level I trauma center with emergent CFA access from January 2016 through toDecember 2020 were reviewed. CFA access was categorized as (1) 7 Fr sheath plus REBOA (REBOA) and (2) 7 Fr sheathwithout REBOA (Sheath). Outcomes included mortality and vascular complications.Results: 157 patients underwent emergent CFA access. Sixty-nine (43.9%) patients had a 7 Fr CFA sheath, and 88(56.1%) progressed to REBOA. The mortality rate was similar (Sheath 30.4% vs. REBOA 34.1%, p = 0.63). The REBOAcohort had a significantly higher complication rate (22.7%) compared to the Sheath cohort (4.3%, p = 0.001).Conclusions: Emergent 7 Fr CFA sheath placement during trauma resuscitation is low risk, suggesting empiricsheath placement is warranted in potential REBOA candidates.

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放置鞘管：急诊7法国股动脉鞘管放置在创伤复苏初期风险较低

背景:我们假设在创伤复苏期间紧急放置7个法国(Fr)股总动脉(CFA)鞘，以治疗潜在的复苏性血管内球囊阻塞主动脉(REBOA)，并发症发生率低。方法:回顾性分析2016年1月至2020年12月在某一级创伤中心急诊进入CFA的创伤患者。CFA准入分为(1)7 Fr鞘加REBOA (REBOA)和(2)7 Fr鞘不加REBOA (sheath)。结果包括死亡率和血管并发症。结果:157例患者接受了紧急CFA准入。69例(43.9%)患者有7 Fr CFA鞘，88例(56.1%)进展为REBOA。死亡率相似(鞘组30.4% vs REBOA组34.1%，p = 0.63)。reboa组的并发症发生率(22.7%)明显高于鞘组(4.3%，p = 0.001)。结论:创伤复苏期间紧急7fr CFA鞘置入的风险较低，提示经验鞘置入在潜在REBOA患者中是必要的。

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来源期刊

Journal of EndoVascular Resuscitation and Trauma Management Multiple-

CiteScore

0.60

自引率

25.00%

发文量