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Is there a role for REBOA? A system assessment
Riyad Karmy-Jones1, Allen Friend2, David Collins3
1Divisions of Trauma/Critical Care and Thoracic/Vascular Surgery PeaceHealth Southwest Washington Medical Center, USA; PeaceHealth St. John's Medical Center, USA; Legacy Emanuel Medical Center, USA.
Introduction:
To analyze our experience to quantify potential need for resuscitative endovascular balloon occlusion of the aorta (REBOA).
Methods:
Retrospective review of patients over a three-year period who presented as a trauma with hemorrhagic shock. Patients were divided into two groups: REBOA Candidate vs. Non-candidates. Injuries, outcomes, and interventions were compared.
Results:
Of 7643 trauma activations, only 37 (0.44%) fit inclusion criteria, of which 16 met criteria for candidacy for potential REBOA placement. The groups did not differ in terms of injury severity, physiology, age, timing of intervention, nor massive transfusion. Survival was linked to TRISS (p = 0.01) and Emergency Room Thoracotomy (p = 0.002). Of Candidates, 8 (50%) had injuries that could have benefited from REBOA, while 7 (44%) had injuries that could be associated with potential harm.
Discussion:
The volume of patients who would potentially benefit from REBOA appears to be small and does not appear to support system wide adoption in the studied region.
Level Of Evidence:
IV.
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