Resuscitative endovascular balloon occlusion of the aorta in combat casualties: The past, present, and future.
Resuscitative endovascular balloon occlusion of the aorta in combat casualties: The past, present, and future.
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DOI：
10.1097/ta.0000000000003166
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发表时间：
2021-08-01
期刊：
影响因子：
--
通讯作者：
Russo RM
中科院分区：
文献类型：
--
作者：
Stokes SC;Theodorou CM;Zakaluzny SA;DuBose JJ;Russo RM
不可压缩性躯干出血是战场上可预防死亡的主要原因。主动脉内球囊闭塞术在20世纪50年代首次用于战斗，但在伊拉克自由行动和持久自由行动之前，军事用途很少。在这些战争中，部署的血管外科医生数量的增加和出血死亡人数的显著增加，导致了复苏血管内球囊阻塞主动脉（REBOA）技术的新适应，增加了其在战斗中的潜在应用。我们描述了REBOA发展的背景，以响应对出血控制的微创干预的需求，并提供了REBOA用于战斗伤亡的所有已发表病例（n=47）的详细回顾。本文描述了REBOA目前的局限性，包括远端缺血和再灌注损伤，以及正在进行的研究工作，以适应REBOA在严峻环境下的长期使用。
Non-compressible torso hemorrhage is a leading cause of preventable death on the battlefield. Intra-aortic balloon occlusion was first used in combat in the 1950s, but military use was rare prior to Operation Iraqi Freedom and Operation Enduring Freedom. During these wars, the combination of an increasing number of deployed vascular surgeons and a significant rise in deaths from hemorrhage resulted in novel adaptations of resuscitative endovascular balloon occlusion of the aorta (REBOA) technology, increasing its potential application in combat. We describe the background of REBOA development in response to a need for minimally invasive intervention for hemorrhage control and provide a detailed review of all published cases (n=47) of REBOA use for combat casualties. The current limitations of REBOA are described, including distal ischemia and reperfusion injury, as well as ongoing research efforts to adapt REBOA for prolonged use in the austere setting.