دورية أكاديمية

The Novel Use of Resuscitative Endovascular Balloon Occlusion of the Aorta to Explore a Retroperitoneal Hematoma in a Hemodynamically Unstable Patient

التفاصيل البيبلوغرافية
العنوان: The Novel Use of Resuscitative Endovascular Balloon Occlusion of the Aorta to Explore a Retroperitoneal Hematoma in a Hemodynamically Unstable Patient
المؤلفون: Rosenthal, Martin D., Raza, Ahsan, Markle, Stephanie, Croft, Chasen A., Mohr, Alicia M., Smith, R. Stephen
المصدر: The American Surgeon ; volume 83, issue 4, page 337-340 ; ISSN 0003-1348 1555-9823
بيانات النشر: SAGE Publications
سنة النشر: 2017
مصطلحات موضوعية: General Medicine
الوصف: Balloon occlusion of the aorta was first described by C.W. Hughes in 1954, when it was used as a tamponade device for three wounded soldiers during the Korean War suffering from intra-abdominal hemorrhage. Currently, the device is indicated in trauma patients as a surrogate for resuscitative thoracotomy. Brenner et al. reported a case series describing the use of resuscitative endovascular balloon occlusion of the aorta (REBOA) in advanced hemorrhagic shock. Their conclusion was that “it is a feasible method for proximal aortic control.” We describe the novel use of REBOA before retroperitoneal hematoma exploration in a hemodynamically unstable patient. Reported is a 19-year-old blunt trauma victim where REBOA was successfully deployed as a means for proximal arterial control before a Zone 1 retroperitoneal hematoma exploration. The source of the patient's hemorrhagic shock was multifactorial: grade V hepatic injury, retrohepatic inferior vena cava laceration, and right renal vein avulsion with Zone 1 retroperitoneal hematoma. Immediate return of perfusion pressure, as systolic pressures increased from 50 to 150 mm Hg. Hemodynamic improvements were accompanied by decreased transfusion and vasopressor requirements. In addition, the surgeons were able to enter the retroperitoneal hematoma under controlled conditions. REBOA is an attractive new tool to gain proximal aortic control in select patients with hemorrhagic shock. It is less morbid, possibly more efficient, and appears to be more effective than resuscitative thoracotomy. REBOA is certainly feasible for proximal aortic control before retroperitoneal exploration, and should be considered in select patients.
نوع الوثيقة: article in journal/newspaper
اللغة: English
DOI: 10.1177/000313481708300418
الإتاحة: https://doi.org/10.1177/000313481708300418Test
حقوق: http://journals.sagepub.com/page/policies/text-and-data-mining-licenseTest
رقم الانضمام: edsbas.7B1F72AC
قاعدة البيانات: BASE