Aortic balloon occlusion (REBOA) in pelvic ring injuries: preliminary results of the ABO Trauma Registry
Aortic balloon occlusion (REBOA) in pelvic ring injuries: preliminary results of the ABO Trauma Registry
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DOI：
10.1007/s13304-020-00735-4
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发表时间：
2020-06-01
影响因子：
2.6
通讯作者：
Horer, Tal M.
中科院分区：
文献类型：
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作者：
Coccolini, Federico;Ceresoli, Marco;Horer, Tal M.
血管内和混合创伤管理（EVTM）最近已被引入治疗严重骨盆环损伤。这种多模式出血管理方法依赖于几种策略，如REBOA（主动脉复苏性血管内球囊闭塞）。关于REBOA用于骨盆环严重损伤患者的数据很少。ABO（主动脉球囊闭塞）创伤登记研究旨在采集所有出血性休克创伤患者的数据，其中管理包括REBOA置入。在ABO登记研究中纳入的所有患者中，72例患者表现为严重骨盆损伤，并且是接受检查的人群。66.7%为男性。平均ISS和中位ISS分别为43和41（SD +/- 13）。12例患者（16.7%）观察到孤立性骨盆损伤。钝性伤68例（94.4%），穿透伤2例（2.8%），混合伤2例（2.8%）。损伤类型：15例患者（23.1%）从高处跌落，49例患者（75.4%）发生交通事故，1例患者（1.5%）发生未指明的撞击。1例患者在院前、43例在急诊室、12例在手术室和16例在血管造影室获得股动脉入路。59名患者（81.9%）的REBOA位于1区，1名患者（1.4%）位于2区，12名患者（16.7%）位于3区。35例患者（48.6%）的主动脉闭塞为部分/周期性，37例患者（51.4%）的主动脉闭塞为完全闭塞。REBOA相关发病率：11.1%。总死亡率为54.2%，早期死亡率（
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 (