关于部分REBOA的即时更新:国防部资助的多中心前性部分REBOA结果研究 (PROMPT) 的初步临床数据和概述
Stephen Gondek1, Susan Hamblin1, Jessica Raley2
1Vanderbilt University Medical Center, Nashville, TN, USA.
Military medicine
|August 20, 2024
概括
与完整的REBOA相比,部分REBOA (逆向内血管气球阻塞大动脉) 减少了诸如损伤等并发症,并减少了复苏需求. 这种方法可以在创伤患者中延长安全的大动脉封闭时间.
科学领域:
- 创伤外科 手术 创伤外科
- 血管内干预 血管内干预
- 控制出血 控制出血
背景情况:
- 逆行性内血管气球阻塞大动脉 (REBOA) 对创伤至关重要,但受到缺血并发症的限制.
- 临床前研究表明,部分REBOA可以缓解缺血并延长安全封闭.
- 像preboa-pro这样的新设备可以控制部分大动脉封闭.
研究的目的:
- 评估新型部分REBOA装置 (pREBOA-PRO) 对延长安全的大动脉封闭时间的影响.
- 为了比较部分REBOA与完整REBOA的临床结果.
- 为潜在的PROMPT试验的设计和终点提供信息.
主要方法:
- 对preboa-pro和ast aorta的200种临床用途的审查.
- 根据临床前和临床数据确定主要终点,包括急性损伤 (AKI).
- 进行功率分析以确定PROMPT研究的患者入学率.
主要成果:
- 与完全REBOA (55%) 相比,部分REBOA显示了较低的AKI率 (33%).
- 在1区的闭塞时间延长了部分REBOA (45分钟) 与完整REBOA (31分钟) 相比.
- 随着部分REBOA的使用,观察到减少了复苏需求,包括25%的红细胞注射量减少.
结论:
- 这项PROMPT研究将提供关于preboa-PRO使用的前性数据.
- 部分REBOA假设比完全REBOA提供好处,包括减少缺血和改善血液动力学.
- 预期的结果将证实,随着部分REBOA,缺血后续减少和复苏需求.
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