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

Issued Date

2020-01-01

Resource Type

Article

ISSN

20383312
2038131X

DOI

10.1007/s13304-020-00735-4

Other identifier(s)

2-s2.0-85080985073

Rights

Mahidol University

Rights Holder(s)

SCOPUS

Bibliographic Citation

Updates in Surgery. (2020)

Suggested Citation

Federico Coccolini, Marco Ceresoli, David T. McGreevy, Mitra Sadeghi, Artai Pirouzram, Asko Toivola, Per Skoog, Koji Idoguchi, Yuri Kon, Tokiya Ishida, Yosuke Matsumura, Junichi Matsumoto, Viktor Reva, Mariusz Maszkowski, Paola Fugazzola, Matteo Tomasoni, Enrico Cicuttin, Luca Ansaloni, Claudia Zaghi, Maria Grazia Sibilla, Camilla Cremonini, Adam Bersztel, Eva Corina Caragounis, Mårten Falkenberg, Lauri Handolin, George Oosthuizen, Endre Szarka, Vassil Manchev, Tongporn Wannatoop, Sung Wook Chang, Boris Kessel, Dan Hebron, Gad Shaked, Miklosh Bala, Carlos A. Ordoñez, Peter Hibert-Carius, Massimo Chiarugi, Kristofer F. Nilsson, Thomas Larzon, Emiliano Gamberini, Vanni Agnoletti, Fausto Catena, Tal M. Hörer Aortic balloon occlusion (REBOA) in pelvic ring injuries: preliminary results of the ABO Trauma Registry. Updates in Surgery. (2020). doi:10.1007/s13304-020-00735-4 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/53888

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Title

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

Author(s)

Federico Coccolini
 Marco Ceresoli
 David T. McGreevy
 Mitra Sadeghi
 Artai Pirouzram
 Asko Toivola
 Per Skoog
 Koji Idoguchi
 Yuri Kon
 Tokiya Ishida
 Yosuke Matsumura
 Junichi Matsumoto
 Viktor Reva
 Mariusz Maszkowski
 Paola Fugazzola
 Matteo Tomasoni
 Enrico Cicuttin
 Luca Ansaloni
 Claudia Zaghi
 Maria Grazia Sibilla
 Camilla Cremonini
 Adam Bersztel
 Eva Corina Caragounis
 Mårten Falkenberg
 Lauri Handolin
 George Oosthuizen
 Endre Szarka
 Vassil Manchev
 Tongporn Wannatoop
 Sung Wook Chang
 Boris Kessel
 Dan Hebron
 Gad Shaked
 Miklosh Bala
 Carlos A. Ordoñez
 Peter Hibert-Carius
 Massimo Chiarugi
 Kristofer F. Nilsson
 Thomas Larzon
 Emiliano Gamberini
 Vanni Agnoletti
 Fausto Catena
 Tal M. Hörer

Other Contributor(s)

Fundación Valle del Lili
 Azienda Ospedaliera-Universitaria Pisana
 Sahlgrenska Universitetssjukhuset
 Ohta Nishinouchi Hospital
 Soroka University Medical Center
 Hille Yaffe Medical Center Israel
 University of KwaZulu-Natal College of Health Sciences
 University of Maryland
 Helsinki University Hospital
 Ospedale M. Bufalini
 St. Marianna University School of Medicine
 Faculty of Medicine, Siriraj Hospital, Mahidol University
 Örebro Universitet
 Azienda Ospedaliero - Universitaria di Parma
 BG-Kliniken Bergmannstrost Halle
 Military Medical Academy, Saint Petersburg
 Chiba University School of Medicine
 Dankook University
 Hadassah University Medical Centre
 Dzhanelidze Research Institute of Emergency Medicine
 Hachinohe City Hospital
 Rinku General Medical Center

Abstract

© 2020, Italian Society of Surgery (SIC). 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.

Keyword(s)

Medicine

Availability

URI

https://repository.li.mahidol.ac.th/handle/20.500.14594/53888

Collections

Scopus 2020