Journal of Trauma and Injury

Original Articles

Perceptions regarding the multidisciplinary treatment of patients with severe trauma in Korea: a survey of trauma specialists: Shin Ae Lee, Yeon Jin Joo, Ye Rim Chang; J Trauma Inj. 2023;36(4):322-328. Published online December 1, 2023; DOI: https://doi.org/10.20408/jti.2023.0045

593 View
32 Download

Abstract PDF Supplementary Material: Purpose
Patients with multiple trauma necessitate assistance from a wide range of departments and professions for their successful reintegration into society. Historically, the primary focus of trauma treatment in Korea has been on reducing mortality rates. This study was conducted with the objective of evaluating the current state of multidisciplinary treatment for patients with severe trauma in Korea. Based on the insights of trauma specialists (i.e., medical professionals), we aim to suggest potential improvements.
Methods
An online questionnaire was conducted among 871 surgical specialists who were members of the Korean Society of Traumatology. The questionnaire covered participant demographics, current multidisciplinary practices, perceived challenges in collaboration with rehabilitation, psychiatry, and anesthesiology departments, and the perceived necessity for multidisciplinary treatment.
Results
Out of the 41 hospitals with which participants were affiliated, only nine conducted multidisciplinary meetings or rounds with nonsurgical departments. The process of transferring patients to rehabilitation facilities was not widespread, and delays in these transfers were frequently observed. Financial constraints were identified by the respondents as a significant barrier to multidisciplinary collaboration. Despite these hurdles, the majority of respondents acknowledged the importance of multidisciplinary treatment, especially in relation to rehabilitation, psychiatry, and anesthesiology involvement.
Conclusions
This survey showed that medical staff specializing in trauma care perceive several issues stemming from the absence of a multidisciplinary system for patient-centered care in Korea. There is a need to develop an effective multidisciplinary treatment system to facilitate the recovery of trauma patients.; Summary

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; J Trauma Inj. 2023;36(1):3-7. Published online September 22, 2022; DOI: https://doi.org/10.20408/jti.2022.0022

1,586 View
60 Download
1 Citations

Purpose
As resuscitative endovascular balloon occlusion of the aorta (REBOA) is performed in an extremely emergent situation, achieving competent clinical practice is mandatory. Although there are several educational courses that teach the REBOA procedure, there have been no reports evaluating the impact of training on clinical practice. Therefore, this study is aimed to evaluate the effects of the course on procedural performance during resuscitation and on clinical outcomes.
Methods
Patients who were managed at a regional trauma center in Dankook University Hospital from August 2016 to February 2018 were included and were grouped as precourse (August 2016–August 2017, n=9) and postcourse (September 2017–February 2018, n=9). Variables regarding injury, parameters regarding REBOA procedure, morbidity, and mortality were prospectively collected and reviewed for comparison between the groups.
Results
Demographics and REBOA variables did not differ between groups. The time required from arterial puncture to balloon inflation was significantly shortened from 9.0 to 5.0 minutes (P=0.003). There were no complications associated with REBOA after the course. Mortality did not show any statistical difference before and after the course.
Conclusions
The endovascular training for REBOA pilot course, which uses a modified form of flipped learning, realistic simulation of ultrasound-guided catheter insertion and balloon manipulation, and competence assessment, significantly improved procedural performance during resuscitation of trauma patients.

Summary

Citations

Citations to this article as recorded by

Nomogram for predicting in-hospital mortality in trauma patients undergoing resuscitative endovascular balloon occlusion of the aorta: a retrospective multicenter study
Byungchul Yu, Jayun Cho, Byung Hee Kang, Kyounghwan Kim, Dong Hun Kim, Sung Wook Chang, Pil Young Jung, Yoonjung Heo, Wu Seong Kang
Scientific Reports.2024;[Epub] CrossRef

Case Report

Repair of traumatic flank hernia with mesh strip suture: a case report: Shin Ae Lee, Ye Rim Chang; J Trauma Inj. 2022;35(Suppl 1):S46-S52. Published online August 16, 2022; DOI: https://doi.org/10.20408/jti.2022.0026

2,759 View
71 Download

Abstract PDF: Traumatic flank hernia is a relatively rare hernia. We report a case of a male patient with severe multiple trauma, including abdominal injury, who presented with flank hernia 3 years postinjury. The hernia was successfully repaired using mesh strips suture, and at the 12-month follow-up, no complications or recurrence was found. Our findings indicate that when it is difficult to secure a sufficient operative field for mesh anchoring in a traumatic flank hernia, a technique of sutured repair with mesh strips may be considered as a treatment option as it requires less dissection. Compared to the conventional planar mesh repair, this technique decreases the risk of injuries and ischemic necrosis of the surrounding tissues.; Summary

Original Article

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; J Trauma Inj. 2020;33(3):144-152. Published online September 30, 2020; DOI: https://doi.org/10.20408/jti.2020.0051

4,420 View
108 Download
6 Citations

Abstract PDF

Purpose

This retrospective multicenter study analyzed trauma patients who underwent resuscitative endovascular balloon occlusion of the aorta (REBOA) in the Republic of Korea.

Methods

This study was conducted from February 2017 to May 2018 at three regional trauma centers in the Republic of Korea. The patients were divided into two groups (cardiopulmonary resuscitation [CPR] and No-CPR) for comparative analysis based on two criteria (complication and mortality) for logistic regression analysis (LRA).

Results

There were significant differences between the CPR and No-CPR groups in mortality (p=0.003) and treatment administered (p=0.016). By LRA for complications, total occlusion has significantly lesser risk than intermittent or partial occlusion in both univariate (odds ratio [OR] 0.06, 95% confidence interval [CI] 0.00-0.36, p=0.01) and multivariate (OR 0.05, 95% CI 0.00-0.38, p=0.01) analyses. The Rescue had a higher risk than the Coda or Reliant in univariate analysis (OR 4.91, 95% CI 1.14-34.25, p=0.05); however, it was not statistically significant in multivariate analysis (OR 6.98, 95% CI 1.03-74.52, p=0.07). By LRA for mortality, the CPR group was the only variable that had a significantly higher risk of mortality than the No-CPR group in both univariate (OR 17.59, 95% CI 3.05-335.25, p=0.01), and multivariate (OR 24.92, 95% CI 3.77-520.51, p=0.01) analyses.

Conclusions

This study was conducted in the early stages of REBOA implementation in the Republic of Korea and showed conflicting results from studies conducted by multiple institutions. Therefore, additional research with more accumulated data is needed.

Summary

Citations

Citations to this article as recorded by

Complications associated with the use of resuscitative endovascular balloon occlusion of the aorta (REBOA): an updated review
Marcelo Augusto Fontenelle Ribeiro Junior, Salman M Salman, Sally M Al-Qaraghuli, Farah Makki, Riham A Abu Affan, Shahin Reza Mohseni, Megan Brenner
Trauma Surgery & Acute Care Open.2024; 9(1): e001267. CrossRef
Contemporary Utilization and Outcomes of Resuscitative Endovascular Balloon Occlusion of the Aorta for Traumatic Noncompressible Torso Hemorrhage in Korea: A Retrospective Multi-Center Study
Yoonjung Heo, Sung Wook Chang, Byungchul Yu, Byung Hee Kang, Pil Young Jung, Kyounghwan Kim, Dong Hun Kim
Journal of Acute Care Surgery.2024; 14(1): 16. CrossRef
On the Feasibility of Using REBOA Technology for the Treatment of Patients with Polytrauma
A. I. Zhukov, N. N. Zadneprovsky, P. A. Ivanov, L. S. Kokov
Russian Sklifosovsky Journal "Emergency Medical Ca.2024; 13(1): 14. CrossRef
Editor's Choice – Systematic Review and Meta-Analysis of Lower Extremity Vascular Complications after Arterial Access for Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA): An Inevitable Concern?
Megan Power Foley, Stewart R. Walsh, Nathalie Doolan, Paul Vulliamy, Morgan McMonagle, Christopher Aylwin
European Journal of Vascular and Endovascular Surg.2023; 66(1): 103. CrossRef
Early experience with resuscitative endovascular balloon occlusion of the aorta for unstable pelvic fractures in the Republic of Korea: a multi-institutional study
Dong Hun Kim, Jonghwan Moon, Sung Wook Chang, Byung Hee Kang
European Journal of Trauma and Emergency Surgery.2023; 49(6): 2495. CrossRef
Comparison between external fixation and pelvic binder in patients with pelvic fracture and haemodynamic instability who underwent various haemostatic procedures
Ji Young Jang, Keum Soek Bae, Byung Hee Kang, Gil Jae Lee
Scientific Reports.2022;[Epub] CrossRef

Case Report

Effects of Resuscitative Endovascular Balloon Occlusion of the Aorta in Neurotrauma: Three Cases: Dong Hun Kim, Ye Rim Chang, Jung-Ho Yun; J Trauma Inj. 2020;33(3):175-180. Published online September 30, 2020; DOI: https://doi.org/10.20408/jti.2020.0047

3,850 View
78 Download
5 Citations

Abstract PDF

Resuscitative endovascular balloon occlusion of the aorta (REBOA) is widely performed as an adjunct to resuscitation or bridge to definitive control of non-compressible torso hemorrhage in patients with hemorrhagic shock. It is a crucial adjunct for the maintenance of cerebral and coronary perfusion during resuscitation. However, in polytrauma patients with concomitant neurotrauma, such as traumatic brain injury (TBI) or spinal cord injury, the physiological effects of REBOA are unclear. In this report on REBOA performed in a clinical setting for polytrauma patients with spinal cord injury or TBI, the physiological effects of REBOA in neurotrauma are reviewed.

Summary

Citations

Citations to this article as recorded by

Resuscitative Endovascular Balloon Occlusion of Aorta Versus Aortic Cross-Clamping by Thoracotomy for Noncompressible Torso Hemorrhage: A Meta-Analysis
Saad Khalid, Mahima Khatri, Mishal Shan Siddiqui, Jawad Ahmed
Journal of Surgical Research.2022; 270: 252. CrossRef
REBOA as a bridge to brain CT in a patient with concomitant brain herniation and haemorrhagic shock - A case report
Luca Bissoni, Emiliano Gamberini, Lorenzo Viola, Carlo Bergamini, Emanuele Russo, Giuliano Bolondi, Vanni Agnoletti
Trauma Case Reports.2022; 38: 100623. CrossRef
Transsplenic Ultrasound-Guided Balloon Positioning During a Zone 1 Resuscitative Endovascular Balloon Occlusion of the Aorta: A Case Report
Yoonjung Heo, Sung Wook Chang, Dong Hun Kim
Journal of Acute Care Surgery.2022; 12(1): 34. CrossRef
Current Approaches to Resuscitative Endovascular Balloon Occlusion of the Aorta Use in Trauma and Obstetrics
Linden O. Lee, Paul Potnuru, Christopher T. Stephens, Evan G. Pivalizza
Advances in Anesthesia.2021; 39: 17. CrossRef
Damage control approach to refractory neurogenic shock: a new proposal to a well-established algorithm
Michael W Parra, Carlos Alberto Ordoñez, David Mejia, Yaset Caicedo, Javier Mauricio Lobato, Oscar Javier Castro, Juan Alfonso Uribe, Fernando Velasquez
Colombia Medica.2021; 52(2): e4164800. CrossRef

Review Article

Educational Simulation Videos for Performing Resuscitative Endovascular Balloon Occlusion of the Aorta: Sung Wook Chang, Dong Hun Kim, Ye Rim Chang; J Trauma Inj. 2020;33(3):140-143. Published online September 30, 2020; DOI: https://doi.org/10.20408/jti.2020.0035

5,079 View
106 Download
2 Citations

Abstract PDF Supplementary Material

Resuscitative endovascular balloon occlusion of the aorta (REBOA) has been accepted as an adjunct procedure for non-compressible torso hemorrhage in patients with hemorrhagic shock. With appropriate indications, REBOA should be performed for resuscitation regardless of the physician’s specialty. Despite its effectiveness in traumatized patients with hemorrhagic shock, performing REBOA has been challenging due to physicians’ lack of experience. Even though training in endovascular skills is mandatory, many physicians cannot undergo sufficient training because of the limited number of endovascular simulation programs. Herein, we share simulation video clips, including those of a vascular circuit model for simulation; sheath preparation; long guidewire and balloon catheter preparation; ultrasound-guided arterial access; sheath insertion or upsizing; and balloon positioning, inflation, and migration. The aim of this study was to provide educational video clips to improve physicians’ endovascular skills for REBOA.

Summary

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
Early experience with resuscitative endovascular balloon occlusion of the aorta for unstable pelvic fractures in the Republic of Korea: a multi-institutional study
Dong Hun Kim, Jonghwan Moon, Sung Wook Chang, Byung Hee Kang
European Journal of Trauma and Emergency Surgery.2023; 49(6): 2495. CrossRef

Case Report

Positioning of Resuscitative Endovascular Balloon Occlusion of the Aorta Catheter: A Case of an Elderly Patient with Concomitant Chest and Pelvic Injury after Blunt Trauma: Dongsub Noh, Jeongseok Yun, Ye Rim Chang; J Trauma Inj. 2020;33(3):186-190. Published online September 30, 2020; DOI: https://doi.org/10.20408/jti.2020.0030

3,313 View
69 Download

Abstract PDF: Resuscitative endovascular balloon occlusion of the aorta (REBOA) has been increasingly used in recent years as a resuscitative adjunct for trauma patients with life-threatening non-compressible torso hemorrhage. By blocking the aorta temporarily with an inflated balloon, REBOA preserves cerebral and coronary perfusion while diminishing exsanguination below the balloon, thereby providing time for resuscitation and definitive bleeding control. When determining the occlusion zone during the REBOA procedure, factors such tortuosity of the aorta, co-occurring minor chest injuries, and the severity of shock must be considered, as well as the main injury site. This paper describes a case of high Zone I REBOA in an elderly patient with a tortuous aorta who had concomitant injuries of the chest and pelvis.; Summary

Original Article

Quality Improvement in the Trauma Intensive Care Unit Using a Rounding Checklist: The Implementation Results: Ye Rim Chang, Sung Wook Chang, Dong Hun Kim, Jeongseok Yun, Jung Ho Yun, Seok Won Lee, Han Cheol Jo, Seok Ho Choi; J Trauma Inj. 2017;30(4):113-119. Published online December 30, 2017; DOI: https://doi.org/10.20408/jti.2017.30.4.113

7,038 View
254 Download

Abstract PDF: Purpose
Despite the numerous protocols and evidence-based guidelines that have been published, application of the therapeutics to eligible patients is limited in clinical settings. Therefore, a rounding checklist was developed to reduce errors of omission and the implementation results were evaluated.
Methods
A checklist consisting of 12 components (feeding, analgesia, sedation, thromboembolic prophylaxis, head elevation, stress ulcer prevention, glucose control, pressure sore prevention, removal of catheter, endotracheal tube and respiration, delirium monitoring, and infection control) was recorded by assigned nurses and then scored by the staff for traumatized, critically ill patients who were admitted in the trauma intensive care unit (ICU) of Dankook University Hospital for more than 2 days. A total of 170 patients (950 sheets) between April and October 2016 were divided into 3 periods (period 1, April to June; period 2, July to August; and period 3, September to October) for the analysis. Questionnaires regarding the satisfaction of the nurses were conducted twice during this implementation period.
Results
Record omission rates decreased across periods 1, 2, and 3 (19.9%, 12.7%, and 4.2%, respectively). The overall clinical application rate of the checklist increased from 90.1% in period 1 to 93.8% in period 3. Among 776 (81.7%) scored sheets, the rates of full compliance were 30.2%, 46.2%, and 45.1% for periods 1, 2, and 3, respectively. The overall mean score of the questionnaire regarding satisfaction also increased from 61.7 to 67.6 points out of 100 points from period 1 to 3.
Conclusions
An ICU rounding checklist could be an effective tool for minimizing the omission of preventative measures and evidence-based therapy for traumatized, critically-ill patients without overburdening nurses. The clinical outcomes of the ICU checklist will be evaluated and reported at an early date.; Summary

First
Prev
Page of 1
Next
Last

Search