Aortic balloon occlusion (REBOA) in pelvic ring injuries: preliminary results of the ABO Trauma Registry

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Aortic balloon occlusion (REBOA) in pelvic ring injuries: preliminary results of the ABO Trauma Registry

Coccolini, F. (author): General, Emergency and Trauma Surgery Department, Pisa University Hospital, Pisa, Italy

Ceresoli, M. (author): General, Emergency and Trauma Surgery Department, Bufalini Hospital, Cesena, Italy

McGreevy, David, 1988- (author): Örebro universitet,Institutionen för medicinska vetenskaper,Department of Cardiothoracic and Vascular Surgery

Sadeghi, M. (author): Department of Vascular Surgery, Västmanlands Hospital Västerås, Västerås, Sweden; Örebro University, Örebro, Sweden

Pirouzram, Artai, 1970- (author): Örebro universitet,Institutionen för medicinska vetenskaper,Department of Cardiothoracic and Vascular Surgery

Toivola, A. (author): Department of Cardiothoracic and Vascular Surgery, Faculty of Medicine and Health, Örebro University, Örebro, Sweden

Skoog, P. (author): Department of Hybrid and Interventional Surgery, Unit of Vascular Surgery, Sahlgrenska University Hospital, Gothenburg, Sweden

Idoguchi, K. (author): Senshu Trauma and Critical Care Center, Rinku General Medical Center, Izumisano, Japan

Kon, Y. (author): Emergency and Critical Care Center, Hachinohe City Hospital, Hachinohe, Japan

Ishida, T. (author): Emergency and Critical Care Center, Ohta Nishinouchi Hospital, Koriyama, Japan

Matsumura, Y. (author): Department of Emergency and Critical Care Medicine, Chiba University Graduate School of Medicine, Chiba, Japan; R Adams Cowley Shock Trauma Center, University of Maryland, College Park, MD, USA

Matsumoto, J. (author): Department of Emergency and Critical Care Medicine, St Marianna University School of Medicine, Kawasaki, Japan

Reva, V. (author): Department of War Surgery, Kirov Military Medical Academy, Saint Petersburg, Russia; Dzhanelidze Research Institute of Emergency Medicine, Saint Petersburg, Russia

Hörer, Tal M., 1971- (author): Department of Vascular Surgery, Västmanlands Hospital Västerås, Västerås, Sweden; Örebro University, Örebro, Sweden,General, Emergency and Trauma Surgery Department, Bufalini Hospital, Cesena, Italy

Fugazzola, P. (author): General, Emergency and Trauma Surgery Department, Bufalini Hospital, Cesena, Italy

Tomasoni, M. (author): General, Emergency and Trauma Surgery Department, Bufalini Hospital, Cesena, Italy

Cicuttin, E. (author): General, Emergency and Trauma Surgery Department, Bufalini Hospital, Cesena, Italy

Ansaloni, L. (author): General, Emergency and Trauma Surgery Department, Bufalini Hospital, Cesena, Italy

Zaghi, C. (author): General, Emergency and Trauma Surgery Department, Bufalini Hospital, Cesena, Italy

Sibilla, M. G. (author): General, Emergency and Trauma Surgery Department, Bufalini Hospital, Cesena, Italy

Cremonini, C. (author): General, Emergency and Trauma Surgery Department, Pisa University Hospital, Pisa, Italy

Bersztel, A. (author): Department of Vascular Surgery, Västmanlands Hospital Västerås, Västerås, Sweden; Örebro University, Örebro, Sweden

Caragounis, Eva Corina (author): Gothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper, Avdelningen för kirurgi,Institute of Clinical Sciences, Department of Surgery,Department of Surgery, Sahlgrenska University Hospital, University of Gothenburg, Gothenburg, Sweden

Falkenberg, M. (author): Department of Radiology, Sahlgrenska University Hospital, Gothenburg, Sweden

Handolin, L. (author): Department of Orthopedics and Traumatology, Helsinki University Hospital, University of Helsinki, Helsinki, Finland

Oosthuizen, G. (author): Department of Surgery, Pietermaritzburg Metropolitan Trauma Service, University of KwaZulu-Natal College of Health Sciences, KwaZulu-Natal, Pietermaritzburg, South Africa

Szarka, E. (author): Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand

Manchev, V. (author): Department of Surgery, Pietermaritzburg Metropolitan Trauma Service, University of KwaZulu-Natal College of Health Sciences, KwaZulu-Natal, Pietermaritzburg, South Africa

Wannatoop, T. (author): Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand

Chang, S. W. (author): Department of Thoracic and Cardiovascular Surgery, Trauma Center, Dankook University Hospital, Cheonan, Republic of Korea

Kessel, B. (author): Department of Surgery, Hillel Yaffe Medical Centre, Hadera, Israel

Hebron, D. (author): Department of Surgery, Hillel Yaffe Medical Centre, Hadera, Israel

Shaked, G. (author): Department of Anesthesiology and Critical Care, Soroka University Medical Center, Ben Gurion University, Beer Sheva, Israel

Bala, M. (author): Trauma and Acute Care Surgery Unit, Hadassah Hebrew University Medical Center, Jerusalem, Israel

Ordoñez, C. A. (author): Division of Trauma and Acute Care Surgery, Department of Surgery, Fundación Valle del Lili and Universidad Del Valle, Cali, Colombia

Hibert-Carius, P. (author): Department of Anesthesiology, Emergency and Intensive Care Medicine, Bergmannstrost Hospital Halle, Halle, Germany

Chiarugi, M. (author): General, Emergency and Trauma Surgery Department, Pisa University Hospital, Pisa, Italy

Nilsson, Kristofer F., 1981- (author): Örebro universitet,Institutionen för medicinska vetenskaper,Department of Cardiothoracic and Vascular Surgery

Larzon, T. (author): Department of Cardiothoracic and Vascular Surgery, Faculty of Medicine and Health, Örebro University, Örebro, Sweden

Gamberini, E. (author): ICU Department Bufalini Hospital, Cesena, Italy

Agnoletti, V. (author): ICU Department Bufalini Hospital, Cesena, Italy

Catena, F. (author): Emergency Surgery Department, Parma University Hospital, Parma, Italy

Hörer, T. M. (author)

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2020-03-04
2020
English.
In: Updates in Surgery. - : Springer Science and Business Media LLC. - 2038-131X .- 2038-3312. ; 2020:72, s. 527-536

Related links:: https://gup.ub.gu.se...; show more...; https://doi.org/10.1...; https://urn.kb.se/re...; show less...

Journal article (peer-reviewed)

Abstract Subject headings

EndoVascular and Hybrid Trauma Management (EVTM) has been recently introduced in the treatment of severe pelvic ring injuries. This multimodal method of hemorrhage management counts on several strategies such as the REBOA (resuscitative endovascular balloon occlusion of the aorta). Few data exist on the use of REBOA in patients with a severely injured pelvic ring. The ABO (aortic balloon occlusion) Trauma Registry is designed to capture data for all trauma patients in hemorrhagic shock where management includes REBOA placement. Among all patients included in the ABO registry, 72 patients presented with severe pelvic injuries and were the population under exam. 66.7% were male. Mean and median ISS were respectively 43 and 41 (SD ± 13). Isolated pelvic injuries were observed in 12 patients (16.7%). Blunt trauma occurred in 68 patients (94.4%), penetrating in 2 (2.8%) and combined in 2 (2.8%). Type of injury: fall from height in 15 patients (23.1%), traffic accident in 49 patients (75.4%), and unspecified impact in 1 patient (1.5%). Femoral access was gained pre-hospital in 1 patient, in emergency room in 43, in operating room in 12 and in angio-suite in 16. REBOA was positioned in zone 1 in 59 patients (81,9%), in zone 2 in 1 (1,4%) and in zone 3 in 12 (16,7%). Aortic occlusion was partial/periodical in 35 patients (48,6%) and total occlusion in 37 patients (51,4%). REBOA associated morbidity rate: 11.1%. Overall mortality rate was 54.2% and early mortality rate (≤ 24 h) was 44.4%. In the univariate analysis, factors related to early mortality (≤ 24 h) are lower pH values (p = 0.03), higher base deficit (p = 0.021), longer INR (p = 0.012), minor increase in systolic blood pressure after the REBOA inflation (p = 0.03) and total aortic occlusion (p = 0.008). None of these values resulted significant in the multivariate analysis. In severe hemodynamically unstable pelvic trauma management, REBOA is a viable option when utilized in experienced centers as a bridge to other treatments; its use might be, however, accompanied with severe-to-lethal complications. © 2020, Italian Society of Surgery (SIC).

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MEDICAL AND HEALTH SCIENCES: MEDICAL AND HEAL ...; and Clinical Medicin ...; and Surgery

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Aortic balloon occlusion (REBOA) in pelvic ring injuries: preliminary results of the ABO Trauma Registry

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