https://scholars.lib.ntu.edu.tw/handle/123456789/631148
標題: | Resuscitative Endovascular Balloon Occlusion of the Aorta for Traumatic Cardiopulmonary Arrest in the Emergency Department: The First Case With Successful Return of Spontaneous Circulation in Taiwan | 作者: | Hsu, Shuo-Ting Fu, Yi-Kai HAO-YANG LIN WEN-CHU CHIANG Chiu, Yu-Chen Sun, Jen-Tang MATTHEW HUEI-MING MA |
關鍵字: | first case; non-compressible torso hemorrhage; out-of-hospital cardiac arrest; resuscitative endovascular balloon occlusion of the aorta (REBOA); trauma | 公開日期: | 1-九月-2022 | 出版社: | TAIWAN SOC EMERGENCY MEDICINE | 卷: | 12 | 期: | 3 | 起(迄)頁: | 126 | 來源出版物: | Journal of acute medicine | 摘要: | Exsanguinating torso hemorrhage is a leading cause of death in trauma patients. Bleeding leads to hypothermia, acidosis, and coagulopathy, the so-called "lethal triad," and creates a vicious cycle. Therefore, bleeding control tops the priority list in the management of trauma patients. Placement of resuscitative endovascular balloon occlusion of the aorta (REBOA) in patients with traumatic non-compressible torso hemorrhage is a developing technique in the emergency departments (EDs) in Taiwan, and it is a possible solution for abdominal and pelvic trauma patients with hemodynamic instability. It not only temporarily controls bleeding below the inflation site but also increases cerebral and coronary circulation. It can create a bridge for definitive care such as an operation or an embolization, possibly preventing death. Compared to thoracotomy followed by an aortic cross clamp, REBOA is a less invasive and possibly, a more efficient way to control the hemorrhage and may lead to better overall survival. The use of REBOA has been proven to be associated with improved survival-to-discharge in severely injured trauma patients. We report a case of out-of-hospital cardiac arrest caused by penetrating injury wherein return of spontaneous circulation was successfully achieved after 39-minute cardiopulmonary resuscitation and REBOA placement in the ED. The REBOA balloon was deflated after bleeding was stopped during the laparotomy operation. The patient was then transferred to the intensive care unit for postoperative care. Unfortunately, the patient passed away approximately 12 hours after the surgery. |
URI: | https://scholars.lib.ntu.edu.tw/handle/123456789/631148 | ISSN: | 2211-5587 | DOI: | 10.6705/j.jacme.202209_12(3).0006 |
顯示於: | 醫學院附設醫院 (臺大醫院) |
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