Is there a place for REBOA in penetrating chest trauma?
Faculty Advisor Name
Abby Massey
Department
Department of Health Professions
Description
Objective: Determine the utility of Resuscitative Balloon Occlusion of the Aorta (REBOA) in penetrating chest trauma patients when compared to open thoracotomy with aortic cross clamp. Design: Systematic literature review. Methods: Searches were made on PubMed, UpToDate, and the Journal of Trauma and Acute Care Surgery using the search term “REBOA.” Articles were included based off of comparisons between REBOA and thoracotomy, mechanism of injury, and number of test subjects. Results: 4 studies were used. One was a controlled trial comparing REBOA and cross clamping in porcine models. One was a case series of two successful deployments of REBOA in penetrating chest trauma patients. One was a trial comparing different versions of REBOA in a controlled trial with porcine models. The fourth and final trial was an analysis of trauma patients seen at a hospital, many of which underwent REBOA, and some of which underwent both REBOA and cross clamping. Conclusion: When compared to open thoracotomy with aortic cross clamping, REBOA is a reasonably tolerated procedure for hemodynamic control. It has been shown to be effective and is associated with less metabolic derangement. Further studies comparing REBOA and Thoracotomy will be useful, however there are great difficulties in creating more of these studies due to the already high rates of morbidity and mortality with penetrating chest trauma patients.
Is there a place for REBOA in penetrating chest trauma?
Objective: Determine the utility of Resuscitative Balloon Occlusion of the Aorta (REBOA) in penetrating chest trauma patients when compared to open thoracotomy with aortic cross clamp. Design: Systematic literature review. Methods: Searches were made on PubMed, UpToDate, and the Journal of Trauma and Acute Care Surgery using the search term “REBOA.” Articles were included based off of comparisons between REBOA and thoracotomy, mechanism of injury, and number of test subjects. Results: 4 studies were used. One was a controlled trial comparing REBOA and cross clamping in porcine models. One was a case series of two successful deployments of REBOA in penetrating chest trauma patients. One was a trial comparing different versions of REBOA in a controlled trial with porcine models. The fourth and final trial was an analysis of trauma patients seen at a hospital, many of which underwent REBOA, and some of which underwent both REBOA and cross clamping. Conclusion: When compared to open thoracotomy with aortic cross clamping, REBOA is a reasonably tolerated procedure for hemodynamic control. It has been shown to be effective and is associated with less metabolic derangement. Further studies comparing REBOA and Thoracotomy will be useful, however there are great difficulties in creating more of these studies due to the already high rates of morbidity and mortality with penetrating chest trauma patients.
