An Early Experience of Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) in the Republic of Korea: A Retrospective Multicenter Study

Park, Joonhyeon; Jang, Sung Woo; Yu, Byungchul; Lee, Gil Jae; Chang, Sung Wook; Kim, Dong Hun; Chang, Young Soo; Jung, Pil Young

doi:10.20408/jti.2020.0051

Cited by 7 publications

(7 citation statements)

References 24 publications

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“…Infection and sepsis rates range from 2% to 36%, while pulmonary-related complications, such as acute respiratory distress syndrome (ARDS) and multisystem organ failure, occur at rates ranging from 7.1% to 17.5%. 12 13 24 56 Gastrointestinal complications show relative consistency, with variability observed in other complications. Additionally, prolonged hypoperfusion can lead to hyperkalemia, acidosis, and coagulopathy.…”

Section: Resultsmentioning

confidence: 96%

Complications associated with the use of resuscitative endovascular balloon occlusion of the aorta (REBOA): an updated review

Fontenelle Ribeiro Junior,

Salman,

Al-Qaraghuli

et al. 2024

Trauma Surg Acute Care Open

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Resuscitative endovascular balloon occlusion of the aorta (REBOA) has become part of the arsenal to temporize patients in shock from severe hemorrhage. REBOA is used in trauma to prevent cardiovascular collapse by preserving heart and brain perfusion and minimizing distal hemorrhage until definitive hemorrhage control can be achieved. Significant side effects, including death, ischemia and reperfusion injuries, severe renal and lung damage, limb ischemia and amputations have all been reported. The aim of this article is to provide an update on complications related to REBOA. REBOA has emerged as a critical intervention for managing severe hemorrhagic shock, aiming to temporize patients and prevent cardiovascular collapse until definitive hemorrhage control can be achieved. However, this life-saving procedure is not without its challenges, with significant reported side effects. This review provides an updated overview of complications associated with REBOA. The most prevalent procedure-related complication is distal embolization and lower limb ischemia, with an incidence of 16% (range: 4–52.6%). Vascular and access site complications are also noteworthy, documented in studies with incidence rates varying from 1.2% to 11.1%. Conversely, bleeding-related complications exhibit lower documentation, with incidence rates ranging from 1.4% to 28.6%. Pseudoaneurysms are less likely, with rates ranging from 2% to 14%. A notable incidence of complications arises from lower limb compartment syndrome and lower limb amputation associated with the REBOA procedure. Systemic complications include acute kidney failure, consistently reported across various studies, with incidence rates ranging from 5.6% to 46%, representing one of the most frequently documented systemic complications. Infection and sepsis are also described, with rates ranging from 2% to 36%. Pulmonary-related complications, including acute respiratory distress syndrome and multisystem organ failure, occur in this population at rates ranging from 7.1% to 17.5%. This comprehensive overview underscores the diverse spectrum of complications associated with REBOA.

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Section: Resultsmentioning

confidence: 96%

Complications associated with the use of resuscitative endovascular balloon occlusion of the aorta (REBOA): an updated review

Fontenelle Ribeiro Junior,

Salman,

Al-Qaraghuli

et al. 2024

Trauma Surg Acute Care Open

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“…In Korea, REBOA was rst used in regional trauma centres in 2016. It is being used as a bridge procedure before other haemostasis in patients with pelvic fracture accompanied by severe shock (23). In our study, 12 patients were treated with REBOA, of which 11 (91.7%) patients underwent PPP and nine (75%) patients underwent PA.…”

Section: Discussionmentioning

confidence: 91%

“…REBOA has recently been increasingly used in patients with haemodynamic instability instead of emergent resuscitative thoracotomy (20)(21)(22)(23). In Korea, REBOA was rst used in regional trauma centres in 2016.…”

Section: Discussionmentioning

confidence: 99%

Comparison between External Fixation and Pelvic Binder in Patients with Pelvic Fracture and Haemodynamic Instability who Underwent Various Haemostatic Procedures

Jang

Bae

Kang

et al. 2021

Preprint

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Haemostatic procedures such as preperitoneal pelvic packing (PPP), pelvic angiography (PA), and internal iliac artery ligation are used for haemorrhage control in pelvic fracture patients with haemodynamic instability. Pelvic external fixation (PEF) and pelvic binder (PB) are usually applied with haemostatic procedures to reduce the pelvic volume. This study aimed to compare the clinical outcomes between patients who underwent PEF and PB. Among 173 patients with pelvic fracture admitted to the emergency room of three regional trauma centres between January 2015 and December 2018, the electronic charts of haemodynamically unstable patients were retrospectively analysed. Among 92 patients included in the analysis, 21 patients underwent PEF and 71 patients underwent PB. There were significant differences in tile classification and laparotomy between the PEF and PB groups (p = 0.018 and p = 0.046). PPP tended to be more frequently preformed in the PEF group (p = 0.074), whereas PA tended to be more commonly performed in the PB group than in the PEF group (p = 0.058). After propensity score matching to adjust for differences in patient characteristics and adjunct haemostatic procedure, there was a significant difference in haemorrhage-induced mortality between the PEF and PB groups (0% vs 25%, p = 0.047). Kaplan–Meier curve analysis also showed a significant difference in haemorrhage-induced mortality between the two groups (log-rank test, p = 0.020). Among the volume reduction procedures performed with other haemostatic procedures in patients with pelvic fracture and haemodynamic instability, PEF significantly reduced haemorrhage-induced mortality compared to PB.

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“…REBOA has recently been increasingly used in patients with haemodynamic instability instead of emergent resuscitative thoracotomy 19 – 22 . In Korea, REBOA was first used in regional trauma centres in 2016.…”

Section: Discussionmentioning

confidence: 99%

“…In Korea, REBOA was first used in regional trauma centres in 2016. It is being used as a bridge procedure before other haemostasis in patients with pelvic fracture accompanied by severe shock 22 . In our study, nearly all patients underwent both the PPP and PA procedures (88.9%).…”

Section: Discussionmentioning

confidence: 99%

Comparison between external fixation and pelvic binder in patients with pelvic fracture and haemodynamic instability who underwent various haemostatic procedures

Jang

Bae

Kang

et al. 2022

Sci Rep

Self Cite

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Haemostatic procedures such as preperitoneal pelvic packing (PPP), pelvic angiography (PA), and internal iliac artery ligation are used for haemorrhage control in pelvic fracture patients with haemodynamic instability. Pelvic external fixation (PEF) and pelvic binder (PB) are usually applied with haemostatic procedures to reduce the pelvic volume. This study aimed to compare the clinical outcomes between patients who underwent PEF and PB. Among 173 patients with pelvic fracture admitted to the emergency room of three regional trauma centres between January 2015 and December 2018, the electronic charts of haemodynamically unstable patients were retrospectively analysed. Among the 84 patients included in the analysis, 20 underwent PEF with or without PB, and 64 underwent only PB. There were significant differences in tile classification and laparotomy between the PEF and PB groups (p = 0.023 and p = 0.032). PPP tended to be more frequently preformed in the PEF group (p = 0.054), whereas PA tended to be more commonly performed in the PB group than in the PEF group (p = 0.054). After propensity score matching to adjust for differences in patient characteristics and adjunct haemostatic procedure, there was no significant difference in 7-day, 30-day, and overall mortality rates between the PEF and PB groups (10.5% vs 21.1%, p = 0.660, 21.1% vs 26.3%, p = 1.000, and 26.3% vs 26.3%, p = 1.000). Cox proportional hazard regression analysis and multivariate analysis for correction of covariates (age, lactate, and abdominal injury) showed that PEF was not an independent factor for 30-day mortality compared with PB (adjusted hazard ratio, 0.526; 95% confidence interval, 0.092–3.002; p = 0.469). Among the volume reduction procedures performed with other haemostatic procedures in patients with pelvic fracture and haemodynamic instability, PEF did not significantly reduce the 30-day mortality rate compared to PB.

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An Early Experience of Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) in the Republic of Korea: A Retrospective Multicenter Study

Cited by 7 publications

References 24 publications

Complications associated with the use of resuscitative endovascular balloon occlusion of the aorta (REBOA): an updated review

Complications associated with the use of resuscitative endovascular balloon occlusion of the aorta (REBOA): an updated review

Comparison between External Fixation and Pelvic Binder in Patients with Pelvic Fracture and Haemodynamic Instability who Underwent Various Haemostatic Procedures

Comparison between external fixation and pelvic binder in patients with pelvic fracture and haemodynamic instability who underwent various haemostatic procedures

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