1. Impact of resuscitative endovascular balloon occlusion of the aorta (REBOA) in traumatic abdominal and pelvic exsanguination: a systematic review and meta-analysis
- Author
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Stefano Granieri, Simone Frassini, Stefania Cimbanassi, Alessandro Bonomi, Sissi Paleino, Laura Lomaglio, Andrea Chierici, Federica Bruno, Raoul Biondi, Salomone Di Saverio, Mansoor Khan, and Christian Cotsoglou
- Subjects
Resuscitation ,Endovascular Procedures ,Hemorrhage ,REBOA ,Balloon Occlusion ,Shock, Hemorrhagic ,Critical Care and Intensive Care Medicine ,Extraperitoneal pelvic packing ,Meta-analysis ,Settore MED/18 - Chirurgia Generale ,Injury Severity Score ,Exsanguination ,Emergency Medicine ,Humans ,Orthopedics and Sports Medicine ,Surgery ,Aortic cross-clamping ,Traumatic torso hemorrhage ,Aorta - Abstract
Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) represents a minimally invasive technique of aortic occlusion (AO). It has been demonstrated to be safe and effective with appropriate training in traumatic hemorrhage with hemodynamic instability; however, its indications are still debated. The aim of this systematic review and meta-analysis is to assess the impact of REBOA on mortality in torso trauma patient with severe non-compressible hemorrhage compared to other temporizing hemostatic techniques.The primary outcome is represented by 24-h, and in-hospital mortality. Secondary outcomes are post-procedural hemodynamic improvement (systolic blood pressure-SBP), mean injury severity score (ISS) differences, treatment-related morbidity, transfusional requirements and identification of prognostic factors.A significant survival benefit at 24 h (RR 0.46; 95% CI 0.27-0.79; IREBOA may represent a valid tool in the initial treatment of multiple sites subdiaphragmatic hemorrhage with refractory hemodynamic instability. However, due to several important limitations of the present study, our findings should be interpreted with caution.Level III according to ELIS (SR/MA with up to two negative criteria).
- Published
- 2022