PMID- 34014887
OWN - NLM
STAT- MEDLINE
DCOM- 20220315
LR  - 20230824
IS  - 1540-0514 (Electronic)
IS  - 1073-2322 (Linking)
VI  - 56
IP  - 4
DP  - 2021 Oct 1
TI  - Targeted Regional Optimization: Increasing the Therapeutic Window for 
      Endovascular Aortic Occlusion In Traumatic Hemorrhage.
PG  - 493-506
LID - 10.1097/SHK.0000000000001814 [doi]
AB  - Resuscitative endovascular balloon occlusion of the aorta (REBOA) allows for 
      effective temporization of exsanguination from non-compressible hemorrhage (NCTH) 
      below the diaphragm. However, the therapeutic window for aortic occlusion is 
      time-limited given the ischemia-reperfusion injury generated. Significant effort 
      has been put into translational research to develop new strategies to alleviate 
      the ischemia-reperfusion injury and extend the application of endoaortic 
      occlusion. Targeted regional optimization (TRO) is a partial REBOA strategy to 
      augment proximal aortic and cerebral blood flow while targeting minimal threshold 
      of distal perfusion beyond the zone of partial aortic occlusion. The objective of 
      TRO is to reduce the degree of ischemia caused by complete aortic occlusion while 
      providing control of distal hemorrhage. This review provides a synopsis of the 
      concept of TRO, pre-clinical, translational experiences with TRO and early 
      clinical outcomes. Early results from TRO strategies are promising; however, 
      further studies are needed prior to large-scale implementation into clinical 
      practice.
CI  - Copyright (c) 2021 by the Shock Society.
FAU - Ronaldi, Alley E
AU  - Ronaldi AE
AD  - Walter Reed National Military Medical Center, The Uniformed Services University 
      of the Health Sciences, Bethesda, Maryland.
FAU - Madurska, Marta J
AU  - Madurska MJ
AD  - R Adams Cowley Shock Trauma Center, University of Maryland Medical System, 
      Maryland.
FAU - Bozzay, Joseph D
AU  - Bozzay JD
AD  - Walter Reed National Military Medical Center, The Uniformed Services University 
      of the Health Sciences, Bethesda, Maryland.
FAU - Polcz, Jeanette E
AU  - Polcz JE
AD  - Walter Reed National Military Medical Center, The Uniformed Services University 
      of the Health Sciences, Bethesda, Maryland.
FAU - Baer, David G
AU  - Baer DG
AD  - Prytime Medical, Boerne, Texas.
FAU - Burmeister, David M
AU  - Burmeister DM
AD  - Walter Reed National Military Medical Center, The Uniformed Services University 
      of the Health Sciences, Bethesda, Maryland.
FAU - White, Paul W
AU  - White PW
AD  - Walter Reed National Military Medical Center, The Uniformed Services University 
      of the Health Sciences, Bethesda, Maryland.
FAU - Rasmussen, Todd E
AU  - Rasmussen TE
AD  - Walter Reed National Military Medical Center, The Uniformed Services University 
      of the Health Sciences, Bethesda, Maryland.
FAU - White, Joseph M
AU  - White JM
AD  - Walter Reed National Military Medical Center, The Uniformed Services University 
      of the Health Sciences, Bethesda, Maryland.
LA  - eng
PT  - Journal Article
PT  - Research Support, U.S. Gov't, Non-P.H.S.
PT  - Review
PL  - United States
TA  - Shock
JT  - Shock (Augusta, Ga.)
JID - 9421564
SB  - IM
MH  - Aorta/*surgery
MH  - *Balloon Occlusion
MH  - *Endovascular Procedures
MH  - Humans
MH  - *Resuscitation
MH  - Shock, Hemorrhagic/etiology/*therapy
MH  - Time Factors
MH  - Wounds and Injuries/*complications/therapy
COIS- DGB is employed by Prytime Medical Inc. and help to write and edit portions of 
      this manuscript as part of his employment responsibilities. AER, MJM, JDB, JEP, 
      DMB, TER, and JMW have no significant financial conflicts of interest related to 
      this paper. DGB is employed by Prytime Medical and help to write and edit 
      portions of this manuscript as part of his employment responsibilities. Prytime 
      Medical produces some of the devices discussed in this manuscript. AER, MJM, JDB, 
      JEP, DMB, TER, and JMW have no significant financial conflicts of interest 
      related to this paper.
EDAT- 2021/05/21 06:00
MHDA- 2022/03/16 06:00
CRDT- 2021/05/20 18:06
PHST- 2021/05/21 06:00 [pubmed]
PHST- 2022/03/16 06:00 [medline]
PHST- 2021/05/20 18:06 [entrez]
AID - 00024382-202110000-00003 [pii]
AID - 10.1097/SHK.0000000000001814 [doi]
PST - ppublish
SO  - Shock. 2021 Oct 1;56(4):493-506. doi: 10.1097/SHK.0000000000001814.