SGEM#258 - By admin - May 25, 2019
Reference: Joseph et al. Nationwide Analysis of Resuscitative Endovascular Balloon Occlusion of the Aorta in Civilian Trauma. JAMA Surgery March 2019.
- "CLINICAL QUESTION: WHAT ARE THE OUTCOMES OF TRAUMA PATIENTS AFTER REBOA PLACEMENT?
- Authors’ Conclusions: “Placement of REBOA in severely injured trauma patients was associated with a higher mortality rate compared with a similar cohort of patients with no placement of REBOA. Patients in the REOBA group also had higher rates of acute kidney injury and lower leg amputations. There is a need for a concerted effort to clearly define when and in which patient population REBOA has benefit.”
- SGEM BOTTOM LINE: REBOA IS CURRENTLY AN INTERVENTION OF UNCERTAIN BENEFIT. ALTHOUGH IT HAS SHOWN PROMISE IN SOME STUDIES, THIS INVESTIGATION LEAVES ITS THERAPEUTIC POTENTIAL IN QUESTION, AND ARGUABLY DEMONSTRATES HARM. THERE MAY BE SUBSTANTIAL BENEFIT IN SELECT GROUPS OF TRAUMA PATIENTS, BUT THESE GROUPS ARE NOT YET KNOWN."