Abstract
Background
Bleeding from hemorrhagic shock can be immediately controlled by blocking the proximal
part of the hemorrhagic point using either resuscitative thoracotomy for aortic cross-clamping
or insertion of a large-caliber (10–14Fr) resuscitative endovascular balloon occlusion
of the aorta (REBOA) device via the femoral artery. However, such methods are very
invasive and have various complications. With recent progress in endovascular treatment,
a low-profile REBOA device (7Fr) has been developed.
Objective
The objective of this study was to report our experience of this low-profile REBOA
device and to evaluate the usefulness of emergency physician−operated REBOA in life-threatening
hemorrhagic shock.
Methods
Ten patients with refractory hemorrhagic shock underwent REBOA using this device via
the femoral artery. All REBOA procedures were performed by emergency physicians. The
success rate of the insertion, vital signs, and REBOA-related complications were evaluated.
Results
Median age was 54 years (interquartile range 33–78 years). The causes of hemorrhagic
shock were trauma (n = 4; 1 blunt and 3 penetrating), ruptured abdominal aortic aneurysm
(n = 3), and obstetric hemorrhage (n = 3). Two patients had cardiopulmonary arrest
upon arrival. REBOA procedure was successful in all patients, and all became hemodynamically
stable to undergo definitive interventions after REBOA. There were no REBOA-related
complications. The mortality rate within 24 h and 30 days was 40%.
Conclusions
This REBOA device was useful for emergency physicians in life-threatening hemorrhagic
shock because of its ease in handling and low invasiveness.
Keywords
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Article info
Publication history
Published online: February 10, 2018
Accepted:
December 17,
2017
Received in revised form:
December 7,
2017
Received:
July 8,
2017
Identification
Copyright
© 2017 Elsevier Inc. All rights reserved.
