A descriptive survey on the use of resuscitative endovascular balloon occlusion of the aorta (REBOA) for pelvic fractures at US level I trauma centers
Abstract Background Resuscitative endovascular balloon occlusion of the aorta (REBOA) is not widely adopted for pelvic fracture management. Western Trauma Association recommends REBOA for hemodynamically unstable pelvic fractures, whereas Eastern Association for the Surgery of Trauma and Advanced Tr...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2019-12-01
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| Series: | Patient Safety in Surgery |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13037-019-0223-3 |
| _version_ | 1818724236238258176 |
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| author | Stephanie Jarvis Michael Kelly Charles Mains Chad Corrigan Nimesh Patel Matthew Carrick Mark Lieser Kaysie Banton David Bar-Or |
| author_facet | Stephanie Jarvis Michael Kelly Charles Mains Chad Corrigan Nimesh Patel Matthew Carrick Mark Lieser Kaysie Banton David Bar-Or |
| author_sort | Stephanie Jarvis |
| collection | DOAJ |
| description | Abstract Background Resuscitative endovascular balloon occlusion of the aorta (REBOA) is not widely adopted for pelvic fracture management. Western Trauma Association recommends REBOA for hemodynamically unstable pelvic fractures, whereas Eastern Association for the Surgery of Trauma and Advanced Trauma Life Support do not. Method Utilizing a prospective cross-sectional survey, all 158 trauma medical directors at American College of Surgeons-verified Level I trauma centers were emailed survey invitations. The study aimed to determine the rate of REBOA use, REBOA indicators, and the treatment sequence of REBOA for hemodynamically unstable pelvic fractures. Results Of those invited, 25% (40/158) participated and 90% (36/40) completed the survey. Nearly half of trauma centers [42% (15/36)] use REBOA for pelvic fracture management. All participants included hemodynamic instability as an indicator for REBOA placement in pelvic fractures. In addition to hemodynamic instability, 29% (4/14) stated REBOA is used for patients who are ineligible for angioembolization, 14% (2/14) use REBOA when interventional radiology is unavailable, 7% (1/14) use REBOA for patients with a negative FAST. Fifty percent (7/14) responded that hemodynamically unstable pelvic fractures exclusively indicates REBOA placement. Hemodynamic instability for pelvic fractures was most commonly defined as systolic blood pressure of < 90 [56% (20/36)]. At centers using REBOA, REBOA was the first line of treatment for hemodynamically unstable pelvic fractures 40% (6/15) of the time. Conclusions There is little consensus on REBOA use for pelvic fractures at US Level I Trauma Centers, except that hemodynamically unstable pelvic fractures consistently indicated REBOA use. |
| first_indexed | 2024-12-17T21:23:12Z |
| format | Article |
| id | doaj.art-fa5a52c1823b41a7b85c2b6f120191c6 |
| institution | Directory Open Access Journal |
| issn | 1754-9493 |
| language | English |
| last_indexed | 2024-12-17T21:23:12Z |
| publishDate | 2019-12-01 |
| publisher | BMC |
| record_format | Article |
| series | Patient Safety in Surgery |
| spelling | doaj.art-fa5a52c1823b41a7b85c2b6f120191c62022-12-21T21:32:06ZengBMCPatient Safety in Surgery1754-94932019-12-011311910.1186/s13037-019-0223-3A descriptive survey on the use of resuscitative endovascular balloon occlusion of the aorta (REBOA) for pelvic fractures at US level I trauma centersStephanie Jarvis0Michael Kelly1Charles Mains2Chad Corrigan3Nimesh Patel4Matthew Carrick5Mark Lieser6Kaysie Banton7David Bar-Or8Trauma ResearchOrthopedic Trauma Surgeon, Penrose HospitalTrauma Systems Director, Centura Health SystemsOrthopedic Trauma Surgeon, Wesley Medical CenterOrthopedic Trauma Surgeon, St. Anthony HospitalTrauma Medical Director, Medical City PlanoTrauma Medical Director, Research Medical CenterTrauma Medical Director, Swedish Medical CenterTrauma ResearchAbstract Background Resuscitative endovascular balloon occlusion of the aorta (REBOA) is not widely adopted for pelvic fracture management. Western Trauma Association recommends REBOA for hemodynamically unstable pelvic fractures, whereas Eastern Association for the Surgery of Trauma and Advanced Trauma Life Support do not. Method Utilizing a prospective cross-sectional survey, all 158 trauma medical directors at American College of Surgeons-verified Level I trauma centers were emailed survey invitations. The study aimed to determine the rate of REBOA use, REBOA indicators, and the treatment sequence of REBOA for hemodynamically unstable pelvic fractures. Results Of those invited, 25% (40/158) participated and 90% (36/40) completed the survey. Nearly half of trauma centers [42% (15/36)] use REBOA for pelvic fracture management. All participants included hemodynamic instability as an indicator for REBOA placement in pelvic fractures. In addition to hemodynamic instability, 29% (4/14) stated REBOA is used for patients who are ineligible for angioembolization, 14% (2/14) use REBOA when interventional radiology is unavailable, 7% (1/14) use REBOA for patients with a negative FAST. Fifty percent (7/14) responded that hemodynamically unstable pelvic fractures exclusively indicates REBOA placement. Hemodynamic instability for pelvic fractures was most commonly defined as systolic blood pressure of < 90 [56% (20/36)]. At centers using REBOA, REBOA was the first line of treatment for hemodynamically unstable pelvic fractures 40% (6/15) of the time. Conclusions There is little consensus on REBOA use for pelvic fractures at US Level I Trauma Centers, except that hemodynamically unstable pelvic fractures consistently indicated REBOA use.https://doi.org/10.1186/s13037-019-0223-3Pelvic fracture managementResuscitative endovascular balloon occlusion of the aorta (REBOA)Level I trauma center |
| spellingShingle | Stephanie Jarvis Michael Kelly Charles Mains Chad Corrigan Nimesh Patel Matthew Carrick Mark Lieser Kaysie Banton David Bar-Or A descriptive survey on the use of resuscitative endovascular balloon occlusion of the aorta (REBOA) for pelvic fractures at US level I trauma centers Patient Safety in Surgery Pelvic fracture management Resuscitative endovascular balloon occlusion of the aorta (REBOA) Level I trauma center |
| title | A descriptive survey on the use of resuscitative endovascular balloon occlusion of the aorta (REBOA) for pelvic fractures at US level I trauma centers |
| title_full | A descriptive survey on the use of resuscitative endovascular balloon occlusion of the aorta (REBOA) for pelvic fractures at US level I trauma centers |
| title_fullStr | A descriptive survey on the use of resuscitative endovascular balloon occlusion of the aorta (REBOA) for pelvic fractures at US level I trauma centers |
| title_full_unstemmed | A descriptive survey on the use of resuscitative endovascular balloon occlusion of the aorta (REBOA) for pelvic fractures at US level I trauma centers |
| title_short | A descriptive survey on the use of resuscitative endovascular balloon occlusion of the aorta (REBOA) for pelvic fractures at US level I trauma centers |
| title_sort | descriptive survey on the use of resuscitative endovascular balloon occlusion of the aorta reboa for pelvic fractures at us level i trauma centers |
| topic | Pelvic fracture management Resuscitative endovascular balloon occlusion of the aorta (REBOA) Level I trauma center |
| url | https://doi.org/10.1186/s13037-019-0223-3 |
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