Current use of Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) in trauma

  • Carlos A. Ordoñez a. President of Panamerican Trauma Society, United States. b. Trauma and Acute Care Surgery Division, Fundación Valle del Lili, Cali, Colombia. c. Universidad del Valle, Cali, Colombia
  • Ramiro Manzano-Nunez a. Trauma and Acute Care Surgery Division, Fundación Valle del Lili, Cali, Colombia. b. Clinical Research Center, Fundación Valle del Lili, Cali, Colombia
  • Ana Milena del Valle Universidad del Valle, Cali, Colombia
  • Fernando Rodriguez Trauma and Acute Care Surgery Division, Fundación Valle del Lili, Cali, Colombia
  • Paola Burbano Trauma and Acute Care Surgery Division, Fundación Valle del Lili, Cali, Colombia
  • Maria Paula Naranjo Clinical Research Center, Fundación Valle del Lili, Cali, Colombia
  • Michael W. Parra Department of Trauma Critical Care, Broward General Level I Trauma Center, Fort Lauderdále, FL, United States
  • Paula Ferrada Virginia Commonwealth Universty, Richmond, VA, United States
  • Mónica Alejandra Solís-Velasco Beth Israel Deaconess Medical Center, Boston, MA, United States
  • Alberto F. García a. Trauma and Acute Care Surgery Division, Fundación Valle del Lili, Cali, Colombia. b. Universidad del Valle, Cali, Colombia
Keywords: Endovascular procedures, Hemorrhage, Review, Aorta, Thoracic, Wounds and injuries

Abstract

Introduction:

Non-compressible torso haemorrhage is the leading cause of death in trauma cases. This has led to the development of new devices to control bleeding, including Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA).

Objective:

To perform a non-systematic review of the literature on the use of Resuscitative Endovascular Balloon Occlusion of the Aorta in trauma.

Materials and methods:

A systematic literature search through Medline was conducted. Articles relevant to our objective were selected. A qualitative and narrative synthesis of results is presented.

Results:

Our qualitative and narrative results show that Resuscitative Endovascular Balloon Occlusion of the Aorta could be a safe and effective intervention for the control of haemorrhage in abdomino-pelvic trauma. Its use is controversial in thoracic trauma. Finally, the performance of this intervention may cause complications.

Conclusion:

Resuscitative Endovascular Balloon Occlusion of the Aorta is an alternative that can be used in damage control surgery. It could be effective for early control of bleeding in patients with non-compressible torso haemorrhage. As a complex intervention, REBOA is in its development phase, and the evidence available preclude us from providing strong recommendations.

References

1. Baker SP. Injuries: the neglected epidemic: Stone Lecture, 1985 America Trauma Society Meeting. J Trauma Acute Care Surg. 1987;27:343-8.

2. Haagsma JA, Graetz N, Bolliger I, Naghavi M, Higashi H, Mullany EC, et al. The global burden of injury: incidence, mortality, disability-adjusted life years and time trends from the Global Burden of Disease study 2013. Inj Prev. 2015;22:3-18.

3. Kauvar DS, Wade CE. The epidemiology and modern management of traumatic hemorrhage: US and international perspectives. Crit Care. 2005;9:S1.

4. Kelly JF, Ritenour AE, McLaughlin DF, Bagg KA, Apodaca AN, Mallak CT, et al. Injury severity and causes of death from Operation Iraqi Freedom and Operation Enduring Freedom: 2003-2004 versus 2006. J Trauma Acute Care Surg. 2008;64:S21-7.

5. Morrison JJ, Rasmussen TE. Noncompressible torso hemorrhage. a review with contemporary definitions and management strategies. Surg Clin N Am. 2012;92:843-58.

6. Kisat M, Morrison JJ, Hashmi ZG, Efron DT, Rasmussen TE, Haider AH. Epidemiology and outcomes ofnon-compressible torso hemorrhage. J Surg Res. 2016;184:414-21.

7. Lamb CM, MacGoey P, Navarro AP, Brooks AJ. Damage control surgery in the era of damage control resuscitation. Br J Anaesth. 2014;113:242-9.

8. Russo RM, Neff LP, Johnson MA, Williams TK. Emerging endovascular therapies for non-compressible torso hemorrhage. Shock. 2016;46 Suppl. 1:12-9.

9. Rabinovici R, Bugaev N. Resuscitative thoracotomy: an update. Scand JSurg. 2014;103:112-9.

10. Ledgerwood AM, Kazmers M, Lucas CE. The role of thoracic aortic occlusion for massive hemoperitoneum. J Trauma Acute Care Surg. 1976;16:610-5.

11. Belenkiy SM, Batchinsky AI, Rasmussen TE, Cancio LC. Resuscitative endovascular balloon occlusion of the aorta for hemorrhage control: past, present and future. J Trauma Acute Care Surg. 2015;79:S236-42.

12. Moore LJ, Brenner M, Kozar RA, Pasley J, Wade CE, Baraniuk MS, et al. Implementation of resuscitative endovascular balloon occlusion of the aorta as an alternative to resuscitative thoracotomy for noncompressible truncal hemorrhage. J Trauma Acute Care Surg. 2014;79:523-32.

13. Hughes C. Use of an intra-aortic balloon catheter tamponade for controlling intra-abdominal hemorrhage in man. Surgery. 1954;36:65-8.

14. Dotter CT, Lukas DS. Acute cor pulmonale an experimental study utilizing a special cardiac catheter. Am J Physiol. 1950;164:254-62.

15. Qasim Z, Brenner M, Menaker J, Scalea T. Resuscitative endovascular balloon occlusion of the aorta. Resuscitation. 2017;96:275-9.

16. Brenner ML, Moore LJ, DuBose JJ, Tyson GH, McNutt MK, Albarado RP, et al. A clinical series of resuscitative endovascular balloon occlusion of the aorta for hemorrhage control and resuscitation. J Trauma Acute Care Surg. 2013;75:506-11.

17. Masamoto H, Uehara H, Gibo M, Okubo E, Sakumoto K, Aoki Y. Elective use of aortic balloon occlusion in cesarean hysterectomy for placenta previa percreta. Gynecol Obstet Invest. 2009;67:92-5.

18. Morrison JJ, Galgon RE, Jansen JO, Cannon JW, Rasmussen TE, Eliason JL, et al. A systematic review of the use of resuscitative endovascular balloon occlusion of the aorta in the management of hemorrhagic shock. J Trauma Acute Care Surg. 2016;80:324-34.

19. Xue-Song L, Chao Y, Kai-Yong Y, Si-Qing H, Heng Z. Surgical excision of extensive sacrococcygeal chordomas assisted by occlusion of the abdominal aorta J Neurosurg Spine. 2010;12:490-6.

20. Finfer SR, Vincent J-L, De Backer D. Critical care medicine circulatory shock. N Engl J Med. 2013;18369:1726-34.

21. Avaro J-P, Mardelle V, Roch A, GilC, de Biasi C, Oliver M, et al. Forty-minute endovascular aortic occlusion increases survival in an experimental model of uncontrolled hemorrhagic shock caused by abdominal trauma. J Trauma Inj Infect Crit Care. 2011;71:720-6.

22. White JM, Cannon JW, Stannard A, Spencer JR, Hancock H, Williams K, et al. A porcine model for evaluating the managemen of noncompressible torso hemorrhage. J Trauma Inj Infect Crit Care. 2011;71 Supplement:S131-8.

23. White JM, Cannon JW, Stannard A, Markov NP, Spencer JR, Rasmussen TE. Endovascular balloon occlusion of the aorta is superior to resuscitative thoracotomy with aortic clamping in a porcine model of hemorrhagic shock. Surgery. 2011;150:400-9.

24. Morrison JJ, Ross JD, Markov NP, Scott DJ, Spencer JR, Rasmussen TE. The inflammatory sequelae of aortic balloon occlusion in hemorrhagic shock. J Surg Res. 2014;191:423-31.

25. Stannard A, Eliason JL, Rasmussen TE. Resuscitative endovascular balloon occlusion of the aorta (REBOA) as an adjunct for hemorrhagic shock. J Trauma Inj Infect Crit Care. 2011;71:1869-72.

26. Morrison JJ, Ross JD, Rasmussen TE, Midwinter MJ, Jansen JO. Resuscitative endovascular balloon occlusion of the aorta: a gap analysis of severely injured UK combat casualties. Shock. 2014;41:388-93.

27. Barnard EBG, Morrison JJ, Madureira RM, Lendrum R, Fragoso-Iííiguez M, Edwards A, et al. Resuscitative endovascular balloon occlusion of the aorta (REBOA): a population based gap analysis of trauma patients in England and Wales. Emerg Med J. 2015;32:926-32.

28. Saito N, Matsumoto H, Yagi T, Hara Y, Hayashida K, Motomura T, et al. Evaluation of the safety and feasibility of resuscitative endovascular balloon occlusion of the aorta. J Trauma Acute Care Surg. 2015;78:897-904.

29. Martinelli T, Thony F, Decléty P, Sengel C, Broux C, Tonetti J, et al. Intra-aortic balloon occlusion to salvage patients with life-threatening hemorrhagic shocks from pelvic fractures. J Trauma. 2010;68:942-8.

30. Biffl WL, Fox CJ, Moore EE. The role of REBOA in the control of exsanguinating torso hemorrhage. J Trauma Acute Care Surg. 2015;78:1054-8.

31. Branco BC, DuBose JJ. Endovascular solutions for the managemen of penetrating trauma: an update on REBOA and axillo-subclavian injuries. Eur J Trauma Emerg Surg. 2016;42:687-94.

32. Demetriades D, Murray J, Charalambides K, Alo K, Velmahos G, Rhee P, et al. Trauma fatalities. J Am Coll Surg. 2004;198:20-6.

33. Hatch QM, Osterhout LM, Ashraf A, Podbielski J, Kozar RA, Wade CE, et al. Current use of damage-control laparotomy, closure rates, and predictor of early fascial closure at the first take-back. J Trauma Acute Care Surg. 2011;70:1429-36.

34. Adamski J. Management of intra-abdominal hemorrhagic shock using REBOA. J Emerg Nurs. 2016;42:287-8.

35. Berg RJ, Inaba K, Okoye O, Karamanos E, Strumwasser A, Chouliaras K, et al. The peril of thoracoabdominal firearm trauma: 984 civilian injuries reviewed. J Trauma Acute Care Surg. 2014;77:684-91.

36. Gupta BK, Khaneja SC, Flores L, Eastlick L, Longmore W, Shaftan GW. The role of intra-aortic balloon occlusion in penetrating abdominal trauma. J Trauma. 1989;29:861-5.

37. Ogura T, Lefor AT, Nakano M, Izawa Y, Morita H. Nonoperative managemen of hemodynamically unstable abdominal trauma patients with angioembolization and resuscitative endovascular balloon occlusion of the aorta. J Trauma Acute Care Surg. 2015;78:132-5.

38. Ordoñez CA, Herrera-Escobar JP, Parra MW, Rodriguez-Ossa PA, Puyana JC. A severe traumatic juxtahepatic blunt venous injury. J Trauma Acute Care Surg. 2016;80:674-6.

39. Schmal H, Markmiller M, Mehlhorn AT, Sudkamp NP. Epidemiology and outcome of complex pelvic injury. Acta Orthop Belg. 2005;71:41-7.

40. Smith W, Williams A, Agudelo J, Shannon M, Morgan S, Stahel P, et al. Early predictors of mortality in hemodynamically unstable pelvis fractures. J Orthop Trauma. 2007;21:31-7.

41. Morrison JJ, Percival TJ, Markov NP, Villamaria C, Scott DJ, Saches KA, et al. Aortic balloon occlusion is effective in controlling pelvic hemorrhage. J Surg Res. 2012;177:341-7.

42. Costantini TW, Coimbra R, Holcomb JB, Podbielski JM, Catalano R, Blackburn A, et al. Current management of hemorrhage from severe pelvic fractures. J Trauma Acute Care Surg. 2016;80:717-25.

43. Papakostidis C, Kanakaris N, Dimitriou R, Giannoudis PV. The role of arterial embolization in controlling pelvic fracture haemorrhage: a systematic review of the literature. Eur J Radiol. 2012;81:897-904.

44. Tran TLN, Brasel KJ, Karmy-Jones R, Rowell S, Schreiber MA, Shatz DV, et al. Western Trauma Association Critical Decisions in Trauma: Management of pelvic fracture with hemodynamic instability?2016 updates. J Trauma Acute Care Surg. 2016;81:1171-4.

45. Abe T, Uchida M, Nagata I, Saitoh D, Tamiya N. Resuscitative endovascular balloon occlusion of the aorta versus aortic cross clamping among patients with critical trauma: a nationwide cohort study in Japan. Crit Care. 2016;20:400.

46. Norii T, Crandall C, Terasaka Y. Survival of severe blunt trauma patients treated with resuscitative endovascular balloon occlusion of the aorta compared with propensity score-adjusted untreated patients. JTrauma Acute Care Surg. 2015;78:721-8.

47. Inoue J, Shiraishi A, Yoshiyuki A, Haruta K, Matsui H, Otomo Y. Resuscitative endovascular balloon occlusion of the aorta might be dangerous in patients with severe torso trauma: a propensity score analysis. J Trauma Acute Care Surg. 2016;80.

48. Scott DJ, Eliason JL, Villamaria C, Morrison JJ, Houston R, Spencer JR, et al.A novel fluoroscopy-free, resuscitative endovascular aortic balloon occlusion system in a model of hemorrhagic shock. J Trauma Acute Care Surg. 2013;75:122-8.

49. Markov NP, Percival TJ, Morrison JJ, Ross JD, Scott DJ, Spencer JR, et al. Physiologic tolerance of descending thoracic aortic balloon occlusion in a swine model of hemorrhagic shock. Surgery (United States). 2013;153:848-56.

50. Tsurukiri J, Akamine I, Sato T, Sakurai M, Okumura E, Moriya M, et al. Resuscitative endovascular balloon occlusion of the aorta for uncontrolled haemorrhagic shock as an adjunct to haemostatic procedures in the acute care setting. Scand J Trauma Resusc Emerg Med. 2016;16:72.

51. Perkins ZB, Lendrum RA, Brohi K. Resuscitative endovascular balloon occlusion of the aorta. Curr Opin Crit Care. 2016; 22:1.

52. Joseph JD, Thomas MS, Megan B, Dimitra S, Kenji I, Jeremy C, et al. The AAST prospective aortic occlusion for resuscitation in trauma and acute care surgery (AORTA) registry: data on contemporary utilization and outcomes of aortic occlusion and resuscitative balloon occlusion of the aorta (REBOA). J Trauma Acute Care Surg. 2016;81:409-19.

53. Long KN, Houston R, Watson JDB, Morrison JJ, Rasmussen TE, Propper BW, et al. Functional outcome after resuscitative endovascular balloon occlusion of the aorta of the proximal and distal thoracic aorta in a swine model of controlled hemorrhage. Ann Vasc Surg. 2015;29:114-21.

54. Russo RM, Williams TK, Grayso JK, Lamb CM, Cannon JW, Clement NF, et al. Extending the golden hour: partial resuscitative endovascular balloon occlusion of the aorta (P-REBOA) in a highly lethal swine liver injury model. J Trauma Acute Care Surg. 2016;80:372-80.

55. Uchino H, Tamura N, Echigoya R, Ikegami T, Fukuoka T. “REBOA” - is it really safe? A case with massive intracranial hemorrhage possibly due to endovascular balloon occlusion of the aorta (REBOA). Am J Case Rep. 2016;17:810-3.

56. Annecke T, Kubitz JC, Langer K, Hilberath JM, Kahr S, Krombach F, et al. Lung injury following thoracic aortic occlusion: comparison of sevoflurane and propofol anaesthesia. Acta Anaesthesiol Scand. 2008;52:977-86.

57. Kralovich KA, Morris DC, Dereczyk BE, Simonett V, Williams M, Rivers EP, et al. Hemodynamic effects of aortic occlusion during hemorrhagic shock and cardiac arrest. J Trauma. 1997;42:1023-8.

58. Seldinger SI. Catheter replacement of the needle in percutaneous arteriography; a new technique. Acta Radiol.1953;39:368-76.

59. Teete WA, Matsumoto J, Idoguchi K, Kon Y, Orita T, Funabiki T, et al. Smaller introducer sheaths for REBOA may be associated with fewer complications. J Trauma Acute Care Surg. 2016;81:1.

60. Matsuda H, Tanaka Y, Hino Y, Matsukawa R, Ozaki N, Okada K, et al. Transbrachial arteria insertion of aortic occlusion balloon catheter in patients with shock from ruptured abdominal aortic aneurysm. J Vasc Surg. 2003;38:1293-6.

61. Morrison JJ, Stannard A, Rasmussen TE, Jansen JO, Tai NRM, Midwinter MJ. Injury pattern and mortality of noncompressible torso hemorrhage in UK combat casualties. J Trauma Acute Care Surg. 2013;75:S263-8.

62. Perkins ZB, Lendrum RA, Brohi K. Resuscitative endovascular balloon occlusion of the aorta: promise, practice, and progress? Curr Opin Crit Care. 2016;22:563-71.

63. Linnebur M, Inaba K, Haltmeier T, Rasmussen TE, Smith J, Mendelsberg R, et al. Emergent non-image-guided resuscitative endovascular balloon occlusion of the aorta (REBOA) catheter placement: a cadaver-based study. J Trauma Acute Care Surg. 2016;81:453-7.

64. Villamaria CY, Eliason JL, Napolitano LM, Stansfield RB, Spencer JR, Rasmussen TE. Endovascular skills for trauma and resuscitative surgery (ESTARS) course: curriculum development, content validation, and program assessment. J Trauma Acute Care Surg. 2014;76, 929-936.

65. Brenner M, Hoehn M, Pasley J, Dubose J, Stein D, Scalea T. Basic endovascular skills for trauma course: bridging the gap between endovascular techniques and the acute care surgeon. J Trauma Acute Care Surg. 2014;77:286-91.

66. Sadek S, Lockey DJ, Lendrum RA, Perkins Z, Price J, Davies GE. Resuscitative endovascular balloon occlusion of the aorta (REBOA) in the pre-hospital setting: an additional resuscitation option for uncontrolled catastrophic haemorrhage. Resuscitation. 2016;107:135-8.
How to Cite
1.
Ordoñez CA, Manzano-Nunez R, del Valle AM, Rodriguez F, Burbano P, Naranjo MP, Parra MW, Ferrada P, Solís-Velasco MA, García AF. Current use of Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) in trauma. Colomb. J. Anesthesiol. [Internet]. 2017Oct.1 [cited 2021Dec.5];45(Supplement):30-8. Available from: https://www.revcolanest.com.co/index.php/rca/article/view/188

Downloads

Download data is not yet available.
Published
2017-10-01
How to Cite
1.
Ordoñez CA, Manzano-Nunez R, del Valle AM, Rodriguez F, Burbano P, Naranjo MP, Parra MW, Ferrada P, Solís-Velasco MA, García AF. Current use of Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) in trauma. Colomb. J. Anesthesiol. [Internet]. 2017Oct.1 [cited 2021Dec.5];45(Supplement):30-8. Available from: https://www.revcolanest.com.co/index.php/rca/article/view/188
Section
Systematic review

More on this topic