dc.contributor.author | Lendrum, R | en_US |
dc.contributor.author | Perkins, Z | en_US |
dc.contributor.author | Chana, M | en_US |
dc.contributor.author | Marsden, M | en_US |
dc.contributor.author | Davenport, R | en_US |
dc.contributor.author | Grier, G | en_US |
dc.contributor.author | Sadek, S | en_US |
dc.contributor.author | Davies, G | en_US |
dc.date.accessioned | 2019-02-01T17:18:57Z | |
dc.date.available | 2018-12-19 | en_US |
dc.date.issued | 2018-12-27 | en_US |
dc.identifier.uri | https://qmro.qmul.ac.uk/xmlui/handle/123456789/55107 | |
dc.description.abstract | AIM: To report the initial experience and outcomes of Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) as an adjunct to pre-hospital resuscitation of patients with exsanguinating pelvic haemorrhage. METHODS: Descriptive case series of consecutive adult patients, treated with pre-hospital Zone III REBOA by a physician-led pre-hospital trauma service, between January 2014 and July 2018. RESULTS: REBOA was attempted in 19 trauma patients (13 successful, six failed attempts) and two non-trauma patients (both successful) with exsanguinating pelvic haemorrhage. Trauma patients were severely injured (median ISS 34, IQR: 27-43) and profoundly hypotensive (median systolic blood pressure [SBP] 57, IQR: 40-68 mmHg). REBOA significantly improved blood pressure (Pre-REBOA median SBP 57, IQR: 35-67 mmHg versus Post- REBOA SBP 114, IQR: 86-132 mmHg; Median of differences 66, 95% CI: 25-74 mmHg; P < 0.001). REBOA was associated with significantly lower risk of pre-hospital cardiac arrest (REBOA 0/13 [0%] versus no REBOA 3/6 [50%], P = 0.021) and death from exsanguination (REBOA 0/13 [0%] versus no REBOA 4/6 [67%], P = 0.004), when compared to patients with a failed attempt. Successful REBOA was associated with improved survival (REBOA 8/13 [62%] versus no REBOA 2/6 [33%]; P = 0.350). Distal arterial thrombus requiring thrombectomy was common in the REBOA group (10/13, 77%). CONCLUSION: REBOA is a feasible pre-hospital resuscitation strategy for patients with exsanguinating pelvic haemorrhage. REBOA significantly improves blood pressure and may reduce the risk of pre-hospital hypovolaemic cardiac arrest and early death due to exsanguination. Distal arterial thrombus formation is common, and should be actively managed. | en_US |
dc.description.sponsorship | Bart’s Health NHS Trust and London’s Air Ambulance. | en_US |
dc.format.extent | 6 - 13 | en_US |
dc.language | eng | en_US |
dc.language.iso | en | en_US |
dc.relation.ispartof | Resuscitation | en_US |
dc.rights | © 2018. This manuscript version is made available under the CC-BY-NC-ND 4.0 license http://creativecommons.org/licenses/by-nc-nd/4.0/ | |
dc.subject | Exsanguinating haemorrhage | en_US |
dc.subject | Exsanguination | en_US |
dc.subject | Hypovolaemic cardiac arrest | en_US |
dc.subject | Junctional haemorrhage | en_US |
dc.subject | Non-compressible torso haemorrhage | en_US |
dc.subject | Pelvic haemorrhage | en_US |
dc.subject | REBOA | en_US |
dc.subject | Resuscitative Endovascular Balloon Occlusion of the Aorta | en_US |
dc.subject | Trauma haemorrhage | en_US |
dc.subject | Trauma resuscitation | en_US |
dc.title | Pre-hospital Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) for exsanguinating pelvic haemorrhage. | en_US |
dc.type | Article | |
dc.identifier.doi | 10.1016/j.resuscitation.2018.12.018 | en_US |
pubs.author-url | https://www.ncbi.nlm.nih.gov/pubmed/30594600 | en_US |
pubs.notes | Not known | en_US |
pubs.publication-status | Published online | en_US |
pubs.volume | 135 | en_US |
dcterms.dateAccepted | 2018-12-15 | en_US |
rioxxterms.funder | Default funder | en_US |
rioxxterms.identifier.project | Default project | en_US |