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Research article
Successfully REBOA Performance: Does Medical Specialty Matter? International Data From the ABOTrauma Registry.
Peter Hilbert-Carius
Department of Anesthesiology, Intensive Care and Emergency Medicine, Bergmannstrost Hospital Halle Mersbuegerstraße 165 06112 Halle (Saale) / Germany
Corresponding Author
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published version at World Journal of Emergency Surgery.
Background
Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) is a minimally invasive procedure being increasingly utilized to prevent patients with non-compressible torso hemorrhage from exsanguination. The increased use of REBOA is giving rise to discussion about “Who is and who should be performing it?”.
Methods
Data from the international ABO (Aortic Balloon Occlusion) Trauma registry from between November 2014 and April 2020 were analyzed concerning the question: By who, how and where is REBOA being performed? The registry collects retrospective and prospective data concerning use of REBOA in trauma patients.
Results
During the study period, 259 patients had been recorded in the registry, 72.5% (n=188) were males with a median (range) age of 46 (10-96) years. REBOA was performed in the ER in 50.5%, in the OR in 41.5% and in the angiography suite in 8% of patients. In 54% of the patients REBOA was performed by surgeons (trauma surgeons 28%, vascular surgeons 22%, general surgeons 4%) and in 46% of the patients by non-surgeons (emergency physicians 31%, radiologists 9.5%, anesthetists 5.5%). Common Femoral Artery (CFA) access was achieved by use of external anatomic landmarks and palpation alone in 119 patients (51%), by cut down in 57 patients (24%), using ultrasound in 49 patients (21%) and by fluoroscopy in 9 patients (4%). Significant differences between surgeons and non-surgeons were found regarding patient’s age, injury severity, access methods, place where REBOA was performed, location patients were taken to from the emergency room and mortality.
Conclusion
A substantial number of both surgical and non-surgical medical disciplines are successfully performing REBOA to an almost equal extent. Surgical cut down is used less frequently as access to the CFA compared with reports in older literature and puncture by use of external anatomic landmarks and palpation alone is used with a high rate of success. Instead of discussing “Who should be performing REBOA?” future research should focus on “Which patient benefits most from REBOA?”.
Keywords
Resuscitative Endovascular Balloon Occlusion of the Aorta, Trauma, Bleeding, Performance, Registry
Figure 1
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CURRENT STATUS: Published
Version 1
Posted 17 Sep, 2020
Published
On 23 Nov, 2020
Published
On 23 Nov, 2020
No community comments so far
Review #1 received
Received 26 Sep, 2020
Review #2 received
Received 24 Sep, 2020
Reviewer #3 agreed
On 16 Sep, 2020
Reviewers invited
Invitations sent on 14 Sep, 2020
Reviewer #1 agreed
On 14 Sep, 2020
Reviewer #2 agreed
On 14 Sep, 2020
Editor assigned
On 13 Sep, 2020
Submission checks complete
On 12 Sep, 2020
Editor invited
On 12 Sep, 2020
First submitted
On 11 Sep, 2020
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Subject Areas
Critical Care & Emergency Medicine
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This preprint is under consideration at World Journal of Emergency Surgery. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research article
Successfully REBOA Performance: Does Medical Specialty Matter? International Data From the ABOTrauma Registry.
Peter Hilbert-Carius
Department of Anesthesiology, Intensive Care and Emergency Medicine, Bergmannstrost Hospital Halle Mersbuegerstraße 165 06112 Halle (Saale) / Germany
Corresponding Author
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Published
Version 1
Posted 17 Sep, 2020
Published
On 23 Nov, 2020
Published
On 23 Nov, 2020
No community comments so far
Review #1 received
Received 26 Sep, 2020
Review #2 received
Received 24 Sep, 2020
Reviewer #3 agreed
On 16 Sep, 2020
Reviewers invited
Invitations sent on 14 Sep, 2020
Reviewer #1 agreed
On 14 Sep, 2020
Reviewer #2 agreed
On 14 Sep, 2020
Editor assigned
On 13 Sep, 2020
Submission checks complete
On 12 Sep, 2020
Editor invited
On 12 Sep, 2020
First submitted
On 11 Sep, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Critical Care & Emergency Medicine
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published version at World Journal of Emergency Surgery.
Background
Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) is a minimally invasive procedure being increasingly utilized to prevent patients with non-compressible torso hemorrhage from exsanguination. The increased use of REBOA is giving rise to discussion about “Who is and who should be performing it?”.
Methods
Data from the international ABO (Aortic Balloon Occlusion) Trauma registry from between November 2014 and April 2020 were analyzed concerning the question: By who, how and where is REBOA being performed? The registry collects retrospective and prospective data concerning use of REBOA in trauma patients.
Results
During the study period, 259 patients had been recorded in the registry, 72.5% (n=188) were males with a median (range) age of 46 (10-96) years. REBOA was performed in the ER in 50.5%, in the OR in 41.5% and in the angiography suite in 8% of patients. In 54% of the patients REBOA was performed by surgeons (trauma surgeons 28%, vascular surgeons 22%, general surgeons 4%) and in 46% of the patients by non-surgeons (emergency physicians 31%, radiologists 9.5%, anesthetists 5.5%). Common Femoral Artery (CFA) access was achieved by use of external anatomic landmarks and palpation alone in 119 patients (51%), by cut down in 57 patients (24%), using ultrasound in 49 patients (21%) and by fluoroscopy in 9 patients (4%). Significant differences between surgeons and non-surgeons were found regarding patient’s age, injury severity, access methods, place where REBOA was performed, location patients were taken to from the emergency room and mortality.
Conclusion
A substantial number of both surgical and non-surgical medical disciplines are successfully performing REBOA to an almost equal extent. Surgical cut down is used less frequently as access to the CFA compared with reports in older literature and puncture by use of external anatomic landmarks and palpation alone is used with a high rate of success. Instead of discussing “Who should be performing REBOA?” future research should focus on “Which patient benefits most from REBOA?”.
Figure 1