Resuscitative endovascular balloon occlusion of the aorta versus aortic cross clamping among patients with critical trauma: a nationwide cohort study in Japan

Measures of aortic occlusion (AO) for resuscitation in patients with severe torso trauma remain controversial. Our aim was to characterize the current use of resuscitative endovascular balloon occlusion of the aorta (REBOA) and resuscitative open aortic cross-clamping (ACC), and to evaluate whether...

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Bibliographic Details
Published in:Critical care (London, England) England), 2016-12, Vol.20 (1), p.400-400, Article 400
Main Authors: Abe, Toshikazu, Uchida, Masatoshi, Nagata, Isao, Saitoh, Daizoh, Tamiya, Nanako
Format: Article
Language:English
Subjects:
Adult
Aged
Aorta - surgery
Aortic aneurysm
Balloon Occlusion - standards
Care and treatment
Cohort Studies
Complications and side effects
Constriction
Critical care
Endovascular Procedures - methods
Female
Hemorrhage
Humans
Injury Severity Score
Japan
Logistic Models
Male
Middle Aged
Mortality
Propensity Score
Registries - statistics & numerical data
Resuscitation - methods
Retrospective Studies
Risk factors
Survival Analysis
Thoracic Injuries - surgery
Thoracic Injuries - therapy
United Kingdom
Wounds and Injuries - surgery
Wounds and Injuries - therapy
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Summary:Measures of aortic occlusion (AO) for resuscitation in patients with severe torso trauma remain controversial. Our aim was to characterize the current use of resuscitative endovascular balloon occlusion of the aorta (REBOA) and resuscitative open aortic cross-clamping (ACC), and to evaluate whether REBOA should be an alternative method to resuscitative open ACC. This study was a retrospective cohort study between 2004 and 2013 from a nationwide trauma registry in Japan. Participants were selected who underwent either REBOA or ACC. Their characteristics, interventions, and outcomes were analyzed to compare REBOA and ACC directly. The primary outcome was in-hospital mortality and the secondary outcome was mortality in the emergency department. Logistic regression analysis was performed to compare the outcomes between REBOA and ACC with adjustment for severity; 1:1 propensity score matching was also performed. Of the 159,157 trauma patients, 903 were eligible based on the selection criteria. Overall, 405/607 patients (67%) who had REBOA died compared to 210/233 patients (90%) who had ACC. Patients with REBOA had higher revised trauma score (RTS) (mean ± SD, 5.2 ± 2.0 vs. 4.2 ± 2.2; P 
ISSN:1364-8535
1466-609X
1364-8535
1366-609X
DOI:10.1186/s13054-016-1577-x