The Role of Prehospital REBOA for Hemorrhage Control in Civilian and Military Austere Settings: A Systematic Review
Despite the success of prehospital resuscitative endovascular balloon occlusion of the aorta (REBOA) in combat and civilian settings, the prevalence of complications and the lack of conclusive evidence has led to uncertainty and controversy. Therefore, this systematic review aimed to evaluate the ro...
| Main Authors: | , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2022-02-01
|
| Series: | Trauma Care |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2673-866X/2/1/6 |
| _version_ | 1827625021039706112 |
|---|---|
| author | Ching Nga Chan Bryar Kadir Zubair Ahmed |
| author_facet | Ching Nga Chan Bryar Kadir Zubair Ahmed |
| author_sort | Ching Nga Chan |
| collection | DOAJ |
| description | Despite the success of prehospital resuscitative endovascular balloon occlusion of the aorta (REBOA) in combat and civilian settings, the prevalence of complications and the lack of conclusive evidence has led to uncertainty and controversy. Therefore, this systematic review aimed to evaluate the role of prehospital REBOA for hemorrhage control in trauma populations. We systematically searched Cochrane, Ovid MEDLINE, EMBASE and Google Scholar for all relevant studies that investigated the efficacy of prehospital REBOA on trauma patients with massive hemorrhage. Primary outcome was evaluated by blood pressure elevation and secondary outcome was measured by 30-day mortality and complications. Our search identified 546 studies, but only six studies met the inclusion and exclusion criteria. Included studies were low to moderate quality due to limitations within the studies. However, all of the studies reported significant elevation of blood pressure and survival, demonstrating the potential benefits of REBOA. For example, the 30-day mortality rate reduced significantly after REBOA, but studies lacked long-term outcome assessments across the continuum of care. Due to the heterogeneity of the results, a meta-analysis was not possible. We conclude that prehospital REBOA is a feasible and effective resuscitative adjunct for shock patients with lethal non-compressible torso hemorrhage. However, due to the unclear causes of complications and the lack of high quality and homogeneous data, the effects of prehospital REBOA were not truly reflected and comparison between groups was not feasible. Thus, further high-quality studies are required to attest the causality between prehospital REBOA and outcomes. |
| first_indexed | 2024-03-09T12:21:44Z |
| format | Article |
| id | doaj.art-54d85f98466e4f29b8961395e2f48945 |
| institution | Directory Open Access Journal |
| issn | 2673-866X |
| language | English |
| last_indexed | 2024-03-09T12:21:44Z |
| publishDate | 2022-02-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Trauma Care |
| spelling | doaj.art-54d85f98466e4f29b8961395e2f489452023-11-30T22:40:03ZengMDPI AGTrauma Care2673-866X2022-02-0121637810.3390/traumacare2010006The Role of Prehospital REBOA for Hemorrhage Control in Civilian and Military Austere Settings: A Systematic ReviewChing Nga Chan0Bryar Kadir1Zubair Ahmed2Institute of Inflammation and Ageing, University of Birmingham, Edgbaston, Birmingham B15 2TT, UKCancer Research UK Clinical Trials Unit (CRCTU), Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham B15 2TT, UKInstitute of Inflammation and Ageing, University of Birmingham, Edgbaston, Birmingham B15 2TT, UKDespite the success of prehospital resuscitative endovascular balloon occlusion of the aorta (REBOA) in combat and civilian settings, the prevalence of complications and the lack of conclusive evidence has led to uncertainty and controversy. Therefore, this systematic review aimed to evaluate the role of prehospital REBOA for hemorrhage control in trauma populations. We systematically searched Cochrane, Ovid MEDLINE, EMBASE and Google Scholar for all relevant studies that investigated the efficacy of prehospital REBOA on trauma patients with massive hemorrhage. Primary outcome was evaluated by blood pressure elevation and secondary outcome was measured by 30-day mortality and complications. Our search identified 546 studies, but only six studies met the inclusion and exclusion criteria. Included studies were low to moderate quality due to limitations within the studies. However, all of the studies reported significant elevation of blood pressure and survival, demonstrating the potential benefits of REBOA. For example, the 30-day mortality rate reduced significantly after REBOA, but studies lacked long-term outcome assessments across the continuum of care. Due to the heterogeneity of the results, a meta-analysis was not possible. We conclude that prehospital REBOA is a feasible and effective resuscitative adjunct for shock patients with lethal non-compressible torso hemorrhage. However, due to the unclear causes of complications and the lack of high quality and homogeneous data, the effects of prehospital REBOA were not truly reflected and comparison between groups was not feasible. Thus, further high-quality studies are required to attest the causality between prehospital REBOA and outcomes.https://www.mdpi.com/2673-866X/2/1/6prehospitalREBOAaortic occlusionhemorrhagetrauma |
| spellingShingle | Ching Nga Chan Bryar Kadir Zubair Ahmed The Role of Prehospital REBOA for Hemorrhage Control in Civilian and Military Austere Settings: A Systematic Review Trauma Care prehospital REBOA aortic occlusion hemorrhage trauma |
| title | The Role of Prehospital REBOA for Hemorrhage Control in Civilian and Military Austere Settings: A Systematic Review |
| title_full | The Role of Prehospital REBOA for Hemorrhage Control in Civilian and Military Austere Settings: A Systematic Review |
| title_fullStr | The Role of Prehospital REBOA for Hemorrhage Control in Civilian and Military Austere Settings: A Systematic Review |
| title_full_unstemmed | The Role of Prehospital REBOA for Hemorrhage Control in Civilian and Military Austere Settings: A Systematic Review |
| title_short | The Role of Prehospital REBOA for Hemorrhage Control in Civilian and Military Austere Settings: A Systematic Review |
| title_sort | role of prehospital reboa for hemorrhage control in civilian and military austere settings a systematic review |
| topic | prehospital REBOA aortic occlusion hemorrhage trauma |
| url | https://www.mdpi.com/2673-866X/2/1/6 |
| work_keys_str_mv | AT chingngachan theroleofprehospitalreboaforhemorrhagecontrolincivilianandmilitaryausteresettingsasystematicreview AT bryarkadir theroleofprehospitalreboaforhemorrhagecontrolincivilianandmilitaryausteresettingsasystematicreview AT zubairahmed theroleofprehospitalreboaforhemorrhagecontrolincivilianandmilitaryausteresettingsasystematicreview AT chingngachan roleofprehospitalreboaforhemorrhagecontrolincivilianandmilitaryausteresettingsasystematicreview AT bryarkadir roleofprehospitalreboaforhemorrhagecontrolincivilianandmilitaryausteresettingsasystematicreview AT zubairahmed roleofprehospitalreboaforhemorrhagecontrolincivilianandmilitaryausteresettingsasystematicreview |