The effectiveness of hybrid treatment for sever multiple trauma: a case of multiple trauma for damage control laparotomy and thoracic endovascular repair

Abstract

BackgroundTime is a crucial factor for the successful early management of the multi-trauma patient. Hybrid operating theaters, which support the integration of surgical treatment and interventional radiology, provide opportunities to reduce the time-to-surgery for life threatening conditions.Case presentationWe describe the early successful treatment of a 54-year-old male who sustained multiple injuries when he was hit by a 1000 kg bale of wheat that fell from a height. He was admitted with hemorrhagic shock due to intra-abdominal bleeding, an unstable fracture of the pelvis, and blunt aortic injury, which was considered to be at high risk of rupture. External fixation was applied to the pelvis in the resuscitation bay, and the patient was transferred to a hybrid operating theater for treatment of both the intra-abdominal hemorrhage and blunt aortic injury. Damage control laparotomy and thoracic endovascular aortic repair were performed uneventfully.ConclusionsHybrid treatment, which combines emergency surgery and intraoperative interventional radiology, provides a prompt and appropriate management approach for the treatment of patients with severe multiple trauma and may improve patient outcomes.

Successfully REBOA performance: does medical specialty matter? International data from the ABOTrauma Registry

“…REBOA is considered to provide a bridge to definitive hemorrhage control and patients who have received REBOA in the ER should be quickly transferred to the OR or AS for definitive bleeding control procedures. Furthermore, a hybrid theater can be an ideal environment to address these complex situations with the need for more than one therapeutic modality [ 38 ].…”

Successfully REBOA Performance: Does Medical Specialty Matter? International Data From the ABOTrauma Registry.

“…REBOA is considered to provide a bridge to de nitive hemorrhage control and patients who have received REBOA in the ER should be quickly transferred to the OR or AS for de nitive bleeding control procedures. Furthermore, a hybrid theatre can be an ideal environment to address these complex situations with the need for more than one therapeutic modality (34).…”

Hybrid Approach for Treatment of Multiple Traumatic Injuries of the Heart, Aorta, and Abdominal Organs

“…Multiple traumas involving various organs could easily be lethal due to the complexity of the injuries involved. The key steps of treatment in such cases are as follows: (1) vital sign stabilization, (2) early detection of the injured site, and (3) serial treatment including surgery, as well as endovascular treatment using a multidisciplinary approach [1]. Most importantly, these interventions should proceed sequentially, without delay, during the golden hour of survival.…”

“…In our case, the patient had severe injuries to the chest and abdomen at the same time. In the field of trauma surgery, it is crucial to prioritize treatment when managing severely injured patients with multiple traumas [1,2]. The concept of damage control surgery is well established for hemodynamically unstable abdominal trauma patients.…”