PMID- 36463569
OWN - NLM
STAT- MEDLINE
DCOM- 20230320
LR  - 20230729
IS  - 1970-9366 (Electronic)
IS  - 1828-0447 (Linking)
VI  - 18
IP  - 2
DP  - 2023 Mar
TI  - Do we need pre-hospital resuscitative endovascular balloon occlusion of the aorta 
      (REBOA) in the civilian helicopter emergency medical services (HEMS)?
PG  - 627-637
LID - 10.1007/s11739-022-03158-8 [doi]
AB  - Pre-hospital resuscitative endovascular balloon occlusion of the aorta (REBOA) 
      can be a life-saving procedure for patients with non-compressible torso 
      hemorrhage. We aimed to evaluate the potential eligibility for REBOA in trauma 
      patients of a civilian helicopter emergency medical service (HEMS) using a 
      stepwise approach. A retrospective analysis using the electronic database 
      (HEMSDER) of "DRF Luftrettung" HEMS covering the period from January 2015 to June 
      2021 was performed. Trauma patients aged >/= 16 years and with a National Advisory 
      Committee for Aeronautics (NACA) score of >/= 4 were assessed for potential REBOA 
      eligibility using two different decision trees based on assumed severe bleeding 
      due to injuries of the abdomen, pelvis, and/or lower extremities and different 
      vital signs on the scene and at hospital handover. Non-parametric statistical 
      methods were used for comparison. A total of 22.426 patients met the inclusion 
      criteria for data analysis. Of these, 0.15-2.24% were possible candidates for 
      pre-hospital REBOA. No significant differences between groups on scene and at 
      hospital handover regarding demographics, assumed injuries, and pre-hospital 
      interventions were found. In the on-scene group, 21.1% of the patients remained 
      unstable even at hospital handover despite pre-hospital care. In the handover 
      group, 42.8% of the patients seemed initially stable but then deteriorated during 
      the pre-hospital course. The number of potential pre-hospital REBOA in severely 
      injured patients with a NACA score of >/= 4 is < 3% or can be even < 1% if more 
      strict criteria are used. There are some patients who may benefit from 
      pre-hospital REBOA as a life-saving procedure. Further research on earlier 
      diagnosis of life-threatening bleeding and proper indications of REBOA in trauma 
      patients is needed.
CI  - (c) 2022. The Author(s), under exclusive licence to Societa Italiana di Medicina 
      Interna (SIMI).
FAU - Hilbert-Carius, Peter
AU  - Hilbert-Carius P
AUID- ORCID: 0000-0002-4704-2377
AD  - Department of Anesthesiology, Intensive Care, Emergency Medicine and Pain 
      Therapy, Bergmannstrost BG Hospital, Merseburgerstr. 165, 06179, Halle (Saale), 
      Germany. peter.hilbert@bergmannstrost.de.
AD  - DRF Luftrettung (German Air Rescue) HEMS, Christoph 84 and 85, Halle (Saale), 
      Germany. peter.hilbert@bergmannstrost.de.
FAU - Schmalbach, Bjarne
AU  - Schmalbach B
AD  - Wissenschaftlicher Arbeitskreis (Scientific Working Group) of DRF Luftrettung, 
      Filderstadt, Germany.
FAU - Wrigge, Hermann
AU  - Wrigge H
AD  - Department of Anesthesiology, Intensive Care, Emergency Medicine and Pain 
      Therapy, Bergmannstrost BG Hospital, Merseburgerstr. 165, 06179, Halle (Saale), 
      Germany.
AD  - Medical Faculty, Martin-Luther-University Halle-Wittenberg, Halle, Germany.
FAU - Schmidt, Merve
AU  - Schmidt M
AD  - Wissenschaftlicher Arbeitskreis (Scientific Working Group) of DRF Luftrettung, 
      Filderstadt, Germany.
FAU - Abu-Zidan, Fikri M
AU  - Abu-Zidan FM
AD  - Consultant of Statistics and Research Methodology, The Research Office, College 
      of Medicine and Health Sciences, United Arab Emirates University, Al-Ain, United 
      Arab Emirates.
FAU - Aschenbrenner, Ulf
AU  - Aschenbrenner U
AD  - Wissenschaftlicher Arbeitskreis (Scientific Working Group) of DRF Luftrettung, 
      Filderstadt, Germany.
AD  - DRF Luftrettung (German Air Rescue) HEMS, Christoph Dortmund, Dortmund, Germany.
FAU - Streibert, Fridolin
AU  - Streibert F
AD  - Department of Anesthesiology, Intensive Care, Emergency Medicine and Pain 
      Therapy, Bergmannstrost BG Hospital, Merseburgerstr. 165, 06179, Halle (Saale), 
      Germany.
AD  - DRF Luftrettung (German Air Rescue) HEMS, Christoph 84 and 85, Halle (Saale), 
      Germany.
LA  - eng
PT  - Journal Article
DEP - 20221204
PL  - Italy
TA  - Intern Emerg Med
JT  - Internal and emergency medicine
JID - 101263418
SB  - IM
MH  - Humans
MH  - Retrospective Studies
MH  - Aorta/injuries
MH  - Hemorrhage/etiology/therapy
MH  - *Balloon Occlusion/methods
MH  - *Emergency Medical Services/methods
MH  - Hospitals
MH  - Resuscitation/methods
MH  - *Endovascular Procedures/methods
MH  - Injury Severity Score
OTO - NOTNLM
OT  - HEMS
OT  - Non-compressible torso hemorrhage
OT  - Pre-hospital care
OT  - REBOA
OT  - Trauma
EDAT- 2022/12/05 06:00
MHDA- 2023/03/21 06:00
CRDT- 2022/12/04 14:30
PHST- 2022/07/08 00:00 [received]
PHST- 2022/11/20 00:00 [accepted]
PHST- 2022/12/05 06:00 [pubmed]
PHST- 2023/03/21 06:00 [medline]
PHST- 2022/12/04 14:30 [entrez]
AID - 10.1007/s11739-022-03158-8 [pii]
AID - 10.1007/s11739-022-03158-8 [doi]
PST - ppublish
SO  - Intern Emerg Med. 2023 Mar;18(2):627-637. doi: 10.1007/s11739-022-03158-8. Epub 
      2022 Dec 4.