PMID- 32707397
OWN - NLM
STAT- MEDLINE
DCOM- 20210310
LR  - 20210310
IS  - 1095-8673 (Electronic)
IS  - 0022-4804 (Linking)
VI  - 256
DP  - 2020 Dec
TI  - Resuscitative Endovascular Balloon Occlusion of Aaorta Use in Nontrauma Emergency 
      General Surgery: A Multi-institutional Experience.
PG  - 149-155
LID - S0022-4804(20)30427-3 [pii]
LID - 10.1016/j.jss.2020.06.034 [doi]
AB  - BACKGROUND: The aim of this study was to determine the current utilization 
      patterns of resuscitative endovascular balloon occlusion of aorta (REBOA) for 
      hemorrhage control in nontrauma patients. METHODS: Data on REBOA use in nontrauma 
      emergency general surgery patients from six centers, 2014-2019, was pooled for 
      analysis. We performed descriptive analyses using Fisher's exact, Student's t, 
      chi-squared, or Mann-Whitney U tests as appropriate. RESULTS: Thirty-seven 
      patients with acute hemorrhage from nontrauma sources were identified. REBOA 
      placement was primarily performed by trauma attendings (20/37, 54%) and vascular 
      attendings (13/37, 35%). In seven patients (19%), balloons were positioned 
      prophylactically but never inflated. In 24 (65%) of 37 patients, REBOA was placed 
      in the operating room. 28/37 balloons (76%) were advanced to zone 1, 8/37 (22%) 
      were advanced to zone 3, and there was one REBOA use in the inferior vena cava. 
      Most common indications were gastrointestinal and peripartum bleeding. In the 30 
      cases of balloon inflation, 24 of 30 (80%) resulted in improved hemodynamics. 
      Eleven of 30 patients (37%) died before discharge. One patient developed a distal 
      embolism, but there were no reports of limb loss. Twelve patients (40% of all 
      REBOA inflations and 63% of survivors) were discharged to home. CONCLUSIONS: 
      REBOA has been used in a range of acutely hemorrhaging emergency general surgery 
      patients with low rates of access-related complications. Mortality is high in 
      this patient population and further research is needed; however, appropriate 
      patient selection and early use may improve survival in these life-threatening 
      cases.
CI  - Copyright (c) 2020 Elsevier Inc. All rights reserved.
FAU - Hatchimonji, Justin S
AU  - Hatchimonji JS
AD  - Department of Surgery, Perelman School of Medicine at the University of 
      Pennsylvania, Philadelphia, Pennsylvania. Electronic address: 
      justin.hatchimonji@uphs.upenn.edu.
FAU - Chipman, Amanda M
AU  - Chipman AM
AD  - R Adams Cowley Shock Trauma Center, Program in Trauma, University of Maryland 
      Medical Center, Baltimore, Maryland.
FAU - McGreevy, David T
AU  - McGreevy DT
AD  - Department of Cardiothoracic and Vascular Surgery, Department of Surgery, Faculty 
      of life science, Orebro University, Sweden.
FAU - Horer, Tal M
AU  - Horer TM
AD  - Department of Cardiothoracic and Vascular Surgery, Department of Surgery, Faculty 
      of life science, Orebro University, Sweden.
FAU - Burruss, Sigrid
AU  - Burruss S
AD  - Department of Surgery, Loma Linda University Medical Center, Loma Linda, 
      California.
FAU - Han, Stephanie
AU  - Han S
AD  - Department of Surgery, Loma Linda University Medical Center, Loma Linda, 
      California.
FAU - Spalding, M Chance
AU  - Spalding MC
AD  - Department of Surgery, OhioHealth Grant Medical Center, Columbus, Ohio.
FAU - Fox, Charles J
AU  - Fox CJ
AD  - Department of Surgery, Denver Health Medical Center, Denver, Colorado.
FAU - Moore, Ernest E
AU  - Moore EE
AD  - Department of Surgery, Denver Health Medical Center, Denver, Colorado.
FAU - Diaz, Jose J
AU  - Diaz JJ
AD  - R Adams Cowley Shock Trauma Center, Program in Trauma, University of Maryland 
      Medical Center, Baltimore, Maryland.
FAU - Cannon, Jeremy W
AU  - Cannon JW
AD  - Department of Surgery, Perelman School of Medicine at the University of 
      Pennsylvania, Philadelphia, Pennsylvania; Leonard Davis Institute of Health 
      Economics, University of Pennsylvania, Philadelphia, Pennsylvania; Department of 
      Surgery, Uniformed Services University of the Health Sciences, Bethesda, 
      Maryland.
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
DEP - 20200721
PL  - United States
TA  - J Surg Res
JT  - The Journal of surgical research
JID - 0376340
SB  - IM
MH  - Adult
MH  - Aged
MH  - Aorta/*surgery
MH  - Balloon Occlusion/adverse effects/*methods
MH  - Endovascular Procedures/adverse effects/*methods
MH  - Female
MH  - Hospital Mortality
MH  - Humans
MH  - Injury Severity Score
MH  - Male
MH  - Middle Aged
MH  - Registries/statistics & numerical data
MH  - Resuscitation/adverse effects/*methods
MH  - Retrospective Studies
MH  - Shock, Hemorrhagic/diagnosis/etiology/mortality/*surgery
MH  - Treatment Outcome
OTO - NOTNLM
OT  - Emergency general surgery
OT  - Hemorrhagic shock
OT  - Quality improvement
OT  - REBOA
EDAT- 2020/07/25 06:00
MHDA- 2021/03/11 06:00
CRDT- 2020/07/25 06:00
PHST- 2020/01/17 00:00 [received]
PHST- 2020/04/27 00:00 [revised]
PHST- 2020/06/16 00:00 [accepted]
PHST- 2020/07/25 06:00 [pubmed]
PHST- 2021/03/11 06:00 [medline]
PHST- 2020/07/25 06:00 [entrez]
AID - S0022-4804(20)30427-3 [pii]
AID - 10.1016/j.jss.2020.06.034 [doi]
PST - ppublish
SO  - J Surg Res. 2020 Dec;256:149-155. doi: 10.1016/j.jss.2020.06.034. Epub 2020 Jul 
      21.