Impact of resuscitative endovascular balloon occlusion of the aorta (REBOA) in traumatic abdominal and pelvic exsanguination: a systematic review and meta-analysis.


Journal

European journal of trauma and emergency surgery : official publication of the European Trauma Society
ISSN: 1863-9941
Titre abrégé: Eur J Trauma Emerg Surg
Pays: Germany
ID NLM: 101313350

Informations de publication

Date de publication:
Oct 2022
Historique:
received: 12 09 2021
accepted: 13 03 2022
pubmed: 22 3 2022
medline: 12 10 2022
entrez: 21 3 2022
Statut: ppublish

Résumé

Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) represents a minimally invasive technique of aortic occlusion (AO). It has been demonstrated to be safe and effective with appropriate training in traumatic hemorrhage with hemodynamic instability; however, its indications are still debated. The aim of this systematic review and meta-analysis is to assess the impact of REBOA on mortality in torso trauma patient with severe non-compressible hemorrhage compared to other temporizing hemostatic techniques. The primary outcome is represented by 24-h, and in-hospital mortality. Secondary outcomes are post-procedural hemodynamic improvement (systolic blood pressure-SBP), mean injury severity score (ISS) differences, treatment-related morbidity, transfusional requirements and identification of prognostic factors. A significant survival benefit at 24 h (RR 0.46; 95% CI 0.27-0.79; I REBOA may represent a valid tool in the initial treatment of multiple sites subdiaphragmatic hemorrhage with refractory hemodynamic instability. However, due to several important limitations of the present study, our findings should be interpreted with caution. Level III according to ELIS (SR/MA with up to two negative criteria).

Identifiants

pubmed: 35307763
doi: 10.1007/s00068-022-01955-6
pii: 10.1007/s00068-022-01955-6
doi:

Types de publication

Journal Article Meta-Analysis Review Systematic Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

3561-3574

Informations de copyright

© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany.

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Auteurs

Stefano Granieri (S)

General Surgery Unit, ASST Brianza, Vimercate Hospital, Via Santi Cosma e Damiano, 10, 20871, Vimercate, Italy. stefano.granieri@asst-brianza.it.

Simone Frassini (S)

University of Pavia, Corso Str. Nuova, 65, 27100, Pavia, Italy.
General Surgery Unit, Department of Surgery, Fondazione I.R.C.C.S. Policlinico San Matteo, Viale Camillo Golgi, 19, 27100, Pavia, Italy.

Stefania Cimbanassi (S)

Emergency and Trauma Surgery, ASST Grande Ospedale Metropolitano Niguarda, Piazza dell'Ospedale Maggiore, 3, 20162, Milan, Italy.

Alessandro Bonomi (A)

University of Milan, Via Festa del Perdono, 7, 20122, Milan, Italy.
General Surgery Unit, ASST Fatebenefratelli-Sacco, Via Giovanni Battista Grassi, 74, 20157, Milan, Italy.

Sissi Paleino (S)

General Surgery Unit, ASST Brianza, Vimercate Hospital, Via Santi Cosma e Damiano, 10, 20871, Vimercate, Italy.
University of Milan, Via Festa del Perdono, 7, 20122, Milan, Italy.

Laura Lomaglio (L)

General Surgery Unit, ASST Brianza, Vimercate Hospital, Via Santi Cosma e Damiano, 10, 20871, Vimercate, Italy.

Andrea Chierici (A)

General Surgery Unit, ASST Brianza, Vimercate Hospital, Via Santi Cosma e Damiano, 10, 20871, Vimercate, Italy.
University of Milan, Via Festa del Perdono, 7, 20122, Milan, Italy.

Federica Bruno (F)

General Surgery Unit, ASST Brianza, Vimercate Hospital, Via Santi Cosma e Damiano, 10, 20871, Vimercate, Italy.

Raoul Biondi (R)

Department of Cardiac Surgery, Institut Mutualiste Montsouris, 42 Boulevard Jourdan, 75014, Paris, France.

Salomone Di Saverio (S)

Department of General Surgery, University of Insubria, ASST Sette Laghi, Viale Luigi Borri, 57, 21100, Varese, Italy.

Mansoor Khan (M)

Department of Surgery, Brighton and Sussex University Hospitals NHS Trust, Kemptown, Brighton, BN2 1DH, UK.

Christian Cotsoglou (C)

General Surgery Unit, ASST Brianza, Vimercate Hospital, Via Santi Cosma e Damiano, 10, 20871, Vimercate, Italy.

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