Revisiting the promise, practice and progress of resuscitative endovascular balloon occlusion of the aorta.
Journal
Current opinion in critical care
ISSN: 1531-7072
Titre abrégé: Curr Opin Crit Care
Pays: United States
ID NLM: 9504454
Informations de publication
Date de publication:
01 12 2023
01 12 2023
Historique:
medline:
2
11
2023
pubmed:
20
10
2023
entrez:
20
10
2023
Statut:
ppublish
Résumé
The use of Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) to temporarily control bleeding and improve central perfusion in critically injured trauma patients remains a controversial topic. In the last decade, select trauma services around the world have gained experience with REBOA. We discuss the recent observational data together with the initial results of the first randomized control trial and provide a view on the next steps for REBOA in trauma resuscitation. While the observational data continue to be conflicting, the first randomized control trial signals that in the UK, in-hospital REBOA is associated with harm. Likely a result of delays to haemorrhage control, views are again split on whether to abandon complex interventions in bleeding trauma patients and to only prioritize transfer to the operating room or to push REBOA earlier into the post injury phase, recognizing that some patients will not survive without intervention. Better understanding of cardiac shock physiology provides a new lens in which to evaluate REBOA through. Patient selection remains a huge challenge. Invasive blood pressure monitoring, combined with machine learning aided decision support may assist clinicians and their patients in the future. The use of REBOA should not delay definitive haemorrhage control in those patients without impending cardiac arrest.
Identifiants
pubmed: 37861182
doi: 10.1097/MCC.0000000000001106
pii: 00075198-202312000-00025
doi:
Types de publication
Review
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
689-695Informations de copyright
Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.
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