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Clinical Study of Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) for Severe Pelvic Fracture and Intra-Abdominal Hemorrhagic Shock Using Continuous Vital Signs

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Technical Report,01 Mar 2016,28 Feb 2017

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University of Maryland Baltimore United States

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Resuscitative balloon occlusion of the aorta REBOA has been clinically demonstrated to stop bleeding below the diaphragm. It has thepotential to significantly decrease blood loss thereby decreasing blood-product resuscitation requirements, improve physiologic parameters,and ultimately lead to increased survival in patients in hemorrhagic shock from severe torso injury. This is a simple endovascular techniquewhich can be taught to forward deployed physicians and has over the past decade vastly improved the survival of ruptured abdominal aorticaneurysm patients. Although the technique is still in its infancy for trauma patients, we predict that the use of intra- aortic balloon occlusionwill improve the survival of trauma patients and reduce morbidity. We have undertaken a 2 phase study to evaluate simulation-based REBOAtraining and the effectiveness of REBOA stabilization of severe intra-abdominal hemorrhagic shock andor pelvic fracture patients. In phase I, asimulator based REBOA training curriculum was developed to train STC clinicians, and its efficacy will be evaluated. Phase 2 is a single center,prospective observational study in which patients with severe hemorrhagic shock andor pelvic fracture admitted to the Trauma ResuscitationUnit of our level 1 trauma center are stabilized with REBOA. Our main objective was to assess the impact on mortality and morbidity afterREBOA. We hypothesized that use of REBOA in cases of NCTH will decrease morbidity and mortality.

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  • Medicine and Medical Research

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