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Complete and Partial Resuscitative Endovascular Balloon Occlusion of the Aorta for Hemorrhagic Shock
Published on: May 19, 2022
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Damage control resuscitation: REBOA as the new fourth pillar
Carlos A Ordoñez1,2,3, Michael W Parra4, José Julián Serna1,2,3,5
1Fundación Valle del Lili. Division of Trauma and Acute Care Surgery, Department of Surgery. Cali, Colombia.
Colombia Medica (Cali, Colombia)
|April 2, 2021
Summary
Damage Control Resuscitation (DCR) combats trauma patient decompensation using Permissive Hypotension, Hemostatic Resuscitation, and Damage Control Surgery (DCS). Resuscitative Balloon Occlusion of the Aorta (REBOA) is proposed as a fourth pillar to improve hemorrhage control and resuscitation.
Area of Science:
- Trauma Surgery
- Emergency Medicine
- Resuscitation Science
Background:
- Damage Control Resuscitation (DCR) addresses metabolic decompensation in severely injured trauma patients.
- Current DCR strategies include Permissive Hypotension, Hemostatic Resuscitation, and Damage Control Surgery (DCS).
Purpose of the Study:
- To review the historical evolution of DCR and DCS.
- To introduce Resuscitative Balloon Occlusion of the Aorta (REBOA) as a novel component of DCR.
- To propose a new DCR paradigm incorporating REBOA.
Main Methods:
- Historical review of Damage Control Resuscitation and Surgery.
- Analysis of advancements in endovascular technology, specifically REBOA.
- Evaluation of REBOA's role in bridging pre-hospital care and surgical bleeding control.
Main Results:
- REBOA facilitates a connection between pre-hospital management and surgical bleeding control (Stage I DCS).
- REBOA proves effective in controlling hemorrhage.
- REBOA is a critical tool for hemodynamic resuscitation in severe blunt and penetrating trauma.
Conclusions:
- REBOA represents a significant advancement in trauma resuscitation.
- A new paradigm for Damage Control Resuscitation is proposed, including REBOA as 'The Fourth Pillar'.
- This expanded DCR model aims to improve outcomes for severely injured patients.
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