当每一分钟都很重要时:手术前的REBOA独立地与确定的出血控制时间延迟15分钟有关
Christina Colosimo1, Sai Krishna Bhogadi1, Omar Hejazi1
1Division of Trauma, Critical Care, Burns, and Emergency Surgery, Department of Surgery, College of Medicine, University of Arizona, Tucson, AZ 85724, USA.
Military medicine
|August 20, 2024
概括
在手术前,主动脉的复苏性内血管气球封闭 (REBOA) 将最终的出血控制延迟平均15分钟. 这种延迟独立地与创伤患者的并发症和死亡率增加有关.
科学领域:
- 创伤外科手术是什么
- 紧急医疗 紧急医疗
- 这是血管外科手术.
背景情况:
- 复苏性内血管气球阻塞大动脉 (REBOA) 是严重出血的关键干预措施.
- 雷博阿对最终手术出血控制时间的影响仍未得到充分研究.
研究的目的:
- 评估手术前接受REBOA (RBS) 对最终控制出血手术的时间的影响.
- 确定RBS与手术延迟,并发症和死亡率之间的关联.
主要方法:
- 对2017-2021年ACS-TQIP数据库的回顾性分析.
- 包括在入院4小时内接受紧急出血控制腹腔切除术的成年患者,但不包括严重头部受伤患者.
- 在手术前分为REBOA (RBS) 和无REBOA (无RBS) 组的分层,使用多变量回归分析.
主要成果:
- 手术前的REBOA (RBS) 与14.5分钟的更长时间进行出血控制手术有关.
- RBS独立地增加了并发症的几率 (aOR=1.72) 和死亡率 (aOR=3.42).
- 该研究确定了32,683名患者,其中342人在RBS组.
结论:
- 手术前的REBOA独立地与最终出血控制的显著延迟有关.
- 这些延迟与患者发病率和死亡率的增加有关.
- 需要对中心特定实践和系统因素进行进一步的研究,以优化REBOA的利用和患者的结果.
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