REBOA as a New Damage Control Component in Hemodynamically Unstable Noncompressible Torso Hemorrhage Patients
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| Formato: | Artículo científico |
| Lenguaje: | en |
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Universidad del Valle
2020
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| _version_ | 1876438038185246720 |
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| author | Carlos A. Ordoñez |
| author_facet | Carlos A. Ordoñez |
| contents | REBOA as a New Damage Control Component in Hemodynamically Unstable Noncompressible Torso Hemorrhage Patients Carlos A. Ordoñez Michael W. Parra Yaset Caicedo Natalia Padilla Fernando Rodríguez-Holguín José Julián Serna Alexander Salcedo Alberto García Claudia Orlas Luis Fernando Pino Ana Milena del Valle David Mejia Juan Carlos Salamea-Molina Megan Brenner Tal Hörer Medicina REBOA wounds gunshot damage control trauma centers Noncompressible torso hemorrhage is one of the leading causes of preventable death worldwide. An efficient and appropriate evaluation of the trauma patient with ongoing hemorrhage is essential to avoid the development of the lethal diamond (hypothermia, coagulopathy, hypocalcemia, and acidosis). Currently, the initial management strategies include permissive hypotension, hemostatic resuscitation, and damage control surgery. However, recent advances in technology have opened the doors to a wide variety of endovascular techniques that achieve these goals with minimal morbidity and limited access. An example of such advances has been the introduction of the Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA), which has received great interest among trauma surgeons around the world due to its potential and versatility in areas such as trauma, gynecology & obstetrics and gastroenterology. This article aims to describe the experience earned in the use of REBOA in noncompressible torso hemorrhage patients. Our results show that REBOA can be used as a new component in the damage control resuscitation of the severely injured trauma patient. To this end, we propose two new deployment algorithms for hemodynamically unstable noncompressible torso hemorrhage patients: one for blunt and another for penetrating trauma. We acknowledge that REBOA has its limitations, which include a steep learning curve, its inherent cost and availability. Although to reach the best outcomes with this new technology, it must be used in the right way, by the right surgeon with the right training and to the right patient. 2020 artículo científico 0120-8322 https://www.redalyc.org/articulo.oa?id=28366176007 https://www.redalyc.org/journal/283/28366176007/ https://www.redalyc.org/journal/283/28366176007/html/ https://www.redalyc.org/journal/283/28366176007/28366176007.epub https://www.redalyc.org/journal/283/28366176007/movil 10.25100/cm.v51i4.4422.4506 en http://www.redalyc.org/revista.oa?id=283 Colombia Médica application/pdf Universidad del Valle Colombia Médica (Colombia) Num.4 Vol.51 |
| format | Artículo científico |
| id | redalyc_28366176007 |
| institution | Redalyc |
| language | en |
| publishDate | 2020 |
| publisher | Universidad del Valle |
| spellingShingle | REBOA as a New Damage Control Component in Hemodynamically Unstable Noncompressible Torso Hemorrhage Patients Carlos A. Ordoñez Medicina REBOA wounds gunshot damage control trauma centers REBOA as a New Damage Control Component in Hemodynamically Unstable Noncompressible Torso Hemorrhage Patients Carlos A. Ordoñez Michael W. Parra Yaset Caicedo Natalia Padilla Fernando Rodríguez-Holguín José Julián Serna Alexander Salcedo Alberto García Claudia Orlas Luis Fernando Pino Ana Milena del Valle David Mejia Juan Carlos Salamea-Molina Megan Brenner Tal Hörer Medicina REBOA wounds gunshot damage control trauma centers Noncompressible torso hemorrhage is one of the leading causes of preventable death worldwide. An efficient and appropriate evaluation of the trauma patient with ongoing hemorrhage is essential to avoid the development of the lethal diamond (hypothermia, coagulopathy, hypocalcemia, and acidosis). Currently, the initial management strategies include permissive hypotension, hemostatic resuscitation, and damage control surgery. However, recent advances in technology have opened the doors to a wide variety of endovascular techniques that achieve these goals with minimal morbidity and limited access. An example of such advances has been the introduction of the Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA), which has received great interest among trauma surgeons around the world due to its potential and versatility in areas such as trauma, gynecology & obstetrics and gastroenterology. This article aims to describe the experience earned in the use of REBOA in noncompressible torso hemorrhage patients. Our results show that REBOA can be used as a new component in the damage control resuscitation of the severely injured trauma patient. To this end, we propose two new deployment algorithms for hemodynamically unstable noncompressible torso hemorrhage patients: one for blunt and another for penetrating trauma. We acknowledge that REBOA has its limitations, which include a steep learning curve, its inherent cost and availability. Although to reach the best outcomes with this new technology, it must be used in the right way, by the right surgeon with the right training and to the right patient. 2020 artículo científico 0120-8322 https://www.redalyc.org/articulo.oa?id=28366176007 https://www.redalyc.org/journal/283/28366176007/ https://www.redalyc.org/journal/283/28366176007/html/ https://www.redalyc.org/journal/283/28366176007/28366176007.epub https://www.redalyc.org/journal/283/28366176007/movil 10.25100/cm.v51i4.4422.4506 en http://www.redalyc.org/revista.oa?id=283 Colombia Médica application/pdf Universidad del Valle Colombia Médica (Colombia) Num.4 Vol.51 |
| title | REBOA as a New Damage Control Component in Hemodynamically Unstable Noncompressible Torso Hemorrhage Patients |
| topic | Medicina REBOA wounds gunshot damage control trauma centers |
| url | https://www.redalyc.org/articulo.oa?id=28366176007 https://www.redalyc.org/journal/283/28366176007/ https://www.redalyc.org/journal/283/28366176007/html/ https://www.redalyc.org/journal/283/28366176007/28366176007.epub https://www.redalyc.org/journal/283/28366176007/movil |