CA repair is the method of choice in CA injury. TS use does not result in a decreased mortality rate or neurologic deficit reduction in patients with severe injuries.
In this ovine model of severe hemorrhagic shock, REBOA can be used to prevent early death from hemorrhage; however, 60 min of occlusion results in significant metabolic derangement and organ damage that offsets this gain.
Our study demonstrates the potential feasibility of REBOA for use during tactical field and en route (flight) care of combat casualties. Further study is needed to determine the optimal training and utilization protocols required to facilitate the effective incorporation of REBOA into military prehospital care capabilities.
Вестник хирургии» • 2017 44 В в е д е н и е. Частота повреждений таза при сочетанных травмах составляет 10,1-42,4 %, при этом нестабильные повреждения тазового кольца встречаются у 39-81,4 % пострадавших [4, 5, 7, 8]. Летальность при травмах таза достигает 15,4 %, а при условии гемодинамической нестабильности пострадавшего возрастает до 40 %, что объясняется продолжающимся массивным внутритазовым кровотечением [1 -3, 6, 9].Выполнение прямого хирургического ге мо стаза при травме таза возможно путём пере вязки или восстановления по вреж дённого со суда. В условиях нестабильной гемодинамики по страдавшего данные способы приводят к дополнительной кровопотере, при этом в условиях слож ной анатомической ориентировки возни кают риски ятрогенных повреждений органов малого таза, крупных магистральных сосудов и нервных ство лов. Одним из способов остановки венозных кро во течений из повреждённых костей таза является там понада таза.Цель исследования -оценить клиническую эффективность внебрюшинной тампонады таза (ВТТ) для обеспечения гемостаза у пострадавших
Endovascular intervention for occlusive arterial trauma is becoming more common in clinical practice. The aim of this study is to present an ovine model of extremity arterial injury for use in future endovascular translational research. Animals under general anesthesia had their left superficial femoral artery exposed, which was bluntly injured over a 2-cm section using a hemostat and injection of air. Occlusion was confirmed on angiography and the flow characteristics measured by ultrasonography. Of five animals enrolled, four occluding lesions were created successfully. Post injury, there was a significant reduction in the median (interquartile range) systolic velocity (cm/sec) on the left (injury) compared to the right (control) side (3.5 (0–16.5) vs. 29 (23.8–43.3); p < 0.001). The ovine superficial femoral artery can be used to consistently produce an occlusive lesion that is suitable for use in the future evaluation of endovascular trauma interventions.
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