复苏性血管内球囊阻塞主动脉(REBOA)的新概念

Q4 Biochemistry, Genetics and Molecular Biology
A. E. Dabiri, Matthew D. Martin, G. Kassab
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引用次数: 0

摘要

创伤性损伤和相关出血在世界范围内对人类健康和福祉的影响是重大的。处理躯干部位出血的方法,被称为不可压缩性躯干出血(NCTH),仍然主要限于使用传统的手术技术。nth患者的总死亡率约为50%。来自阿富汗和伊拉克战争的研究表明,高达80%的可能存活的病人死于不受控制的失血。市售的复苏血管内球囊阻断主动脉(REBOA)是一种经皮快速控制创伤后躯干出血的装置。柔软的球囊经股动脉插入,在胸主动脉或腹主动脉充气,为腹部、骨盆或腹股沟/下肢提供流入控制。最近的研究表明,REBOA由于过度膨胀和可能的主动脉或髂动脉破裂而具有主动脉损伤的固有风险。一种新的方法是解决气球尺寸和过度膨胀的问题。我们提出了一种新的概念,用于创伤设施的动脉闭塞,以消除动脉损伤和血管破裂的风险,通过实时球囊直径剖面测量,以确保适当的膨胀。提出的概念被称为智能复苏血管内球囊阻塞(SREBO),它将在以下方面具有创新性:1)它将采用基于电导的导航技术来定位主动脉中球囊部署的理想位置,2)球囊可以使用电导导管技术确定适当充气的时间。这项技术将消除动脉破裂的风险,并简化创伤设施或医疗诊所的程序,而无需大量培训。结果可以显示在手持设备上。这种新型装置有可能拯救创伤中的平民或在战场上受伤的士兵。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
New Concept in Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA)
: The world-wide impact of traumatic injury and associated hemorrhage on human health and well-being is significant. Methods to manage bleeding from sites within the torso, referred to as non-compressible torso hemorrhage (NCTH), remain largely limited to the use of conventional operative techniques. The overall mortality rate of patients with NCTH is approximately 50%. Studies from the wars in Afghanistan and Iraq have suggested that up to 80% of potentially survivable patients die as a result of uncontrolled exsanguinating hemorrhage. The commercially available resuscitative endovascular balloon occlusion of the aorta (REBOA) is a percutaneous device for the rapid control of torso hemorrhage in trauma. A compliant balloon is inserted via the femoral artery and inflated in the thoracic or abdominal aorta, providing inflow control of the abdomen, pelvis, or groin/lower extremities. Recent studies indicate that REBOA carries an inherent risk of aortic injury due to over-inflation and possible risk of aortic or iliac artery rupture. A new approach is to resolve the issue of balloon sizing and over-inflation. We propose a novel concept to be used in trauma facility for arterial occlusion to eliminate arterial injury and the risk of vascular rupture through real time balloon diameter profile measurements to ensure proper inflation. The proposed concept, called Smart Resuscitative Endovascular Balloon Occlusion (SREBO) will be novel in the following aspects: 1) It will have electrical conductance-based navigation technology to target the desired site of balloon deployment in the aorta, 2) The balloon can determine the time of proper inflation using electrical conductance catheter technology. This technology would eliminate the risk of arterial rupture and simplify the procedure in the trauma facility or medical clinics without significant training. The results can be displayed on a handheld device. This novel device has the potential to save civilians in trauma or soldiers injured on the battlefield.
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来源期刊
Molecular & Cellular Biomechanics
Molecular & Cellular Biomechanics CELL BIOLOGYENGINEERING, BIOMEDICAL&-ENGINEERING, BIOMEDICAL
CiteScore
1.70
自引率
0.00%
发文量
21
期刊介绍: The field of biomechanics concerns with motion, deformation, and forces in biological systems. With the explosive progress in molecular biology, genomic engineering, bioimaging, and nanotechnology, there will be an ever-increasing generation of knowledge and information concerning the mechanobiology of genes, proteins, cells, tissues, and organs. Such information will bring new diagnostic tools, new therapeutic approaches, and new knowledge on ourselves and our interactions with our environment. It becomes apparent that biomechanics focusing on molecules, cells as well as tissues and organs is an important aspect of modern biomedical sciences. The aims of this journal are to facilitate the studies of the mechanics of biomolecules (including proteins, genes, cytoskeletons, etc.), cells (and their interactions with extracellular matrix), tissues and organs, the development of relevant advanced mathematical methods, and the discovery of biological secrets. As science concerns only with relative truth, we seek ideas that are state-of-the-art, which may be controversial, but stimulate and promote new ideas, new techniques, and new applications.
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