Feasibility and clinical outcome of resuscitative endovascular balloon occlusion of the aorta in patients with traumatic shock: A-single center 5-year experience

Abstract text (incl. references and figure legends)

Abstract

Introduction

Resuscitative endovascular balloon occlusion of the aorta(REBOA) has been recently performed as an adjunct to resuscitation for patients with traumatic shock. However, the effectiveness of REBOA is still debated due to differences in indications of each center and the lack of medical records. The purpose of this study is to investigate the effectiveness and feasibility of REBOA by analyzing the clinical results from a single center.

Material & Methods

From August 2016 to September 2021, 96 patients who underwent REBOA at a regional trauma center according to the center's treatment algorithm for traumatic shock patients were included. Medical records, including the time of the decision to proceed with the REBOA procedure, time of operation, and type of aortic occlusion; and clinical outcomes were collected prospectively and analyzed retrospectively.

Results

The overall success rate of the operation was 97.9%. Excluding the 5 cases in which no inflation was performed after balloon insertion, the survival rate of 89 patients was 32.6%. In the survival group, blood pressure was high before REBOA procedure(p=0.002) and after aortic occlusion(p=0.03). The total aortic occlusion time was short in the survivor group(p=0.001), and the number of partial aortic occlusion was significantly high(p=0.014). The non-survival group had more acidosis(p<0.001) with a higher lactate concentration(p<0.001).

Conclusions

REBOA could be feasible as a bridge therapy for resuscitation in patients with traumatic shock. Prompt and accurate decision-making to perform REBOA and followed by damage control surgery could improve patients" survival rate and clinical outcomes.

References

Belenkiy SM, Batchinsky AI, Rasmussen TE, Cancio LC. Resuscitative endovascular balloon occlusion of the aorta for hemorrhage control: Past, present, and future. J Trauma Acute Care Surg. 2015;79(4 Suppl 2):S236-42

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