{"title":"复苏性血管内球囊阻塞主动脉(REBOA)的新概念","authors":"A. E. Dabiri, Matthew D. Martin, G. Kassab","doi":"10.32604/mcb.2019.07310","DOIUrl":null,"url":null,"abstract":": 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.","PeriodicalId":48719,"journal":{"name":"Molecular & Cellular Biomechanics","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"New Concept in Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA)\",\"authors\":\"A. E. Dabiri, Matthew D. Martin, G. Kassab\",\"doi\":\"10.32604/mcb.2019.07310\",\"DOIUrl\":null,\"url\":null,\"abstract\":\": 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.\",\"PeriodicalId\":48719,\"journal\":{\"name\":\"Molecular & Cellular Biomechanics\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2020-01-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Molecular & Cellular Biomechanics\",\"FirstCategoryId\":\"1087\",\"ListUrlMain\":\"https://doi.org/10.32604/mcb.2019.07310\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q4\",\"JCRName\":\"Biochemistry, Genetics and Molecular Biology\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Molecular & Cellular Biomechanics","FirstCategoryId":"1087","ListUrlMain":"https://doi.org/10.32604/mcb.2019.07310","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"Biochemistry, Genetics and Molecular Biology","Score":null,"Total":0}
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.
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.