- Pitfalls, Complications, and Necessity of Education about REBOA: A Single Regional Trauma Center Study
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Sol Kim, Jae Sik Chung, Sung Woo Jang, Pil Young Jung
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J Trauma Inj. 2020;33(3):153-161. Published online September 30, 2020
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DOI: https://doi.org/10.20408/jti.2020.0049
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Abstract
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- Purpose
Resuscitative endovascular balloon occlusion of the aorta (REBOA) is an emergency procedure and extremely time-dependent, and the proficiency of the physician is important. Due to a lack of REBOA education programs in Republic of Korea, few physicians have been trained in the procedure. In this study, we examined how REBOA education affects clinical outcomes in a single center.
Methods
A retrospective study conducted from February 2017 to June 2020 at a regional trauma center. We collected data of patients who underwent REBOA and analyzed the factors that influenced the outcome. The patients were divided into the educated and non-educated groups (based on REBOA training received by their physicians), and the success and failure groups.
Results
A total of 24 patients underwent REBOA during the study. There were eight patients in the success group and 16 patients in the failure group. There are no significant differences between the educated and non-educated groups in sex, age, ISS, shock, injury-to-REBOA time, injury mechanism, injury sites, arrest, access site, type of catheter, type of REBOA, target Zone, mortality, and the result of REBOA. The non-educated group had a higher risk for failure compared to the educated group in multivariate analysis (odds ratio [OR] 154.64, 95% confidence interval [CI] 1.11-22.60).
Conclusions
Failure in REBOA is harmful to patients. The risk of failure is increased in the non-educated group. Physicians working in the trauma center or emergency department need to complete the REBOA education program.
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Summary
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Citations
Citations to this article as recorded by
- Feasibility and Clinical Outcomes of Resuscitative Endovascular Balloon Occlusion of the Aorta in Patients with Traumatic Shock: A Single-Center 5-Year Experience
Gyeongho Lee, Dong Hun Kim, Dae Sung Ma, Seok Won Lee, Yoonjung Heo, Hancheol Jo, Sung Wook Chang Journal of Chest Surgery.2023; 56(2): 108. CrossRef - Analysis of procedural performance after a pilot course on endovascular training for resuscitative endovascular balloon occlusion of the aorta
Sung Wook Chang, Dong Hun Kim, Dae Sung Ma, Ye Rim Chang Journal of Trauma and Injury.2023; 36(1): 3. CrossRef
- Resuscitative Endovascular Balloon occlusion of the aorta in Impending Traumatic arrest: Is It Effective?
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Jae Sik Chung, Oh Hyun Kim, Seongyup Kim, Ji Young Jang, Gyo Jin An, Pil Young Jung
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J Trauma Inj. 2020;33(1):23-30. Published online March 30, 2020
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DOI: https://doi.org/10.20408/jti.2020.001
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5,685
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148
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2
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Abstract
PDF
- Purpose
Hemorrhagic shock is the leading cause of death in trauma patients worldwide. Resuscitative endovascular balloon occlusion of the aorta (REBOA) is a technique used to improve the hemodynamic stability of patients with traumatic shock and to temporarily control arterial hemorrhage. However, further research is required to determine whether REBOA with cardiopulmonary resuscitation (CPR) in near-arrest or arrest trauma patients can help resuscitation. We analyzed trauma patients who underwent REBOA according to their CPR status and evaluated the effects of REBOA in arrest situations.
Methods
This study was a retrospective single-regional trauma center study conducted at a tertiary medical institution from February 2017 to November 2019. We evaluated the mortality of severely injured patients who underwent REBOA and analyzed the factors that influenced the outcome. Patients were divided into CPR and non-CPR groups.
Results
We reviewed 1,596 trauma patients with shock, of whom 23 patients underwent REBOA (1.4%). Two patients were excluded due to failure and a repeated attempt of REBOA. The Glasgow Coma Scale score was lower in the CPR group than in the non-CPR group (p=0.009). Blood pressure readings at the emergency room were lower in the CPR group than in the non-CPR group, including systolic blood pressure (p=0.012), diastolic blood pressure (p=0.002), and mean arterial pressure (p=0.008). In addition, the mortality rate was higher in the CPR group (100%) than in the non-CPR group (50%) (p=0.012). The overall mortality rate was 76.2%.
Conclusions
Our study suggests that if REBOA is deemed necessary in a timely manner, it is better to perform REBOA before an arrest occurs. Therefore, appropriate protocols, including pre-hospital REBOA, should be constructed to demonstrate the effectiveness of REBOA in reducing mortality in arrest or impending arrest patients.
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Summary
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Citations
Citations to this article as recorded by
- An Early Experience of Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) in the Republic of Korea: A Retrospective Multicenter Study
Joonhyeon Park, Sung Woo Jang, Byungchul Yu, Gil Jae Lee, Sung Wook Chang, Dong Hun Kim, Ye Rim Chang, Pil Young Jung Journal of Trauma and Injury.2020; 33(3): 144. CrossRef - Pitfalls, Complications, and Necessity of Education about REBOA: A Single Regional Trauma Center Study
Sol Kim, Jae Sik Chung, Sung Woo Jang, Pil Young Jung Journal of Trauma and Injury.2020; 33(3): 153. CrossRef
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