Targeted Regional Optimization: Increasing the Therapeutic Window for Endovascular Aortic Occlusion In Traumatic Hemorrhage.
Journal
Shock (Augusta, Ga.)
ISSN: 1540-0514
Titre abrégé: Shock
Pays: United States
ID NLM: 9421564
Informations de publication
Date de publication:
01 10 2021
01 10 2021
Historique:
pubmed:
21
5
2021
medline:
16
3
2022
entrez:
20
5
2021
Statut:
ppublish
Résumé
Resuscitative endovascular balloon occlusion of the aorta (REBOA) allows for effective temporization of exsanguination from non-compressible hemorrhage (NCTH) below the diaphragm. However, the therapeutic window for aortic occlusion is time-limited given the ischemia-reperfusion injury generated. Significant effort has been put into translational research to develop new strategies to alleviate the ischemia-reperfusion injury and extend the application of endoaortic occlusion. Targeted regional optimization (TRO) is a partial REBOA strategy to augment proximal aortic and cerebral blood flow while targeting minimal threshold of distal perfusion beyond the zone of partial aortic occlusion. The objective of TRO is to reduce the degree of ischemia caused by complete aortic occlusion while providing control of distal hemorrhage. This review provides a synopsis of the concept of TRO, pre-clinical, translational experiences with TRO and early clinical outcomes. Early results from TRO strategies are promising; however, further studies are needed prior to large-scale implementation into clinical practice.
Identifiants
pubmed: 34014887
doi: 10.1097/SHK.0000000000001814
pii: 00024382-202110000-00003
doi:
Types de publication
Journal Article
Research Support, U.S. Gov't, Non-P.H.S.
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
493-506Informations de copyright
Copyright © 2021 by the Shock Society.
Déclaration de conflit d'intérêts
DGB is employed by Prytime Medical Inc. and help to write and edit portions of this manuscript as part of his employment responsibilities. AER, MJM, JDB, JEP, DMB, TER, and JMW have no significant financial conflicts of interest related to this paper. DGB is employed by Prytime Medical and help to write and edit portions of this manuscript as part of his employment responsibilities. Prytime Medical produces some of the devices discussed in this manuscript. AER, MJM, JDB, JEP, DMB, TER, and JMW have no significant financial conflicts of interest related to this paper.
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