학술논문

Resuscitative endovascular balloon occlusion of the aorta in combat casualties: The past, present, and future
Document Type
article
Source
Journal of Trauma and Acute Care Surgery. 91(2S)
Subject
Biomedical and Clinical Sciences
Clinical Sciences
Cardiovascular
Good Health and Well Being
Aorta
Balloon Occlusion
Forecasting
History
20th Century
History
21st Century
Humans
Resuscitation
War-Related Injuries
REBOA
resuscitative endovascular balloon occlusion of the aorta
austere environments
Clinical sciences
Nursing
Language
Abstract
BackgroundNoncompressible torso hemorrhage is a leading cause of preventable death on the battlefield. Intra-aortic balloon occlusion was first used in combat in the 1950s, but military use was rare before Operation Iraqi Freedom and Operation Enduring Freedom. During these wars, the combination of an increasing number of deployed vascular surgeons and a significant rise in deaths from hemorrhage resulted in novel adaptations of resuscitative endovascular balloon occlusion of the aorta (REBOA) technology, increasing its potential application in combat. We describe the background of REBOA development in response to a need for minimally invasive intervention for hemorrhage control and provide a detailed review of all published cases (n = 47) of REBOA use for combat casualties. The current limitations of REBOA are described, including distal ischemia and reperfusion injury, as well as ongoing research efforts to adapt REBOA for prolonged use in the austere setting.Level of evidenceLevel V.