Focused Empiricism and the Efficacy of Resuscitative Endovascular Balloon Occlusion of the Aorta

Original Investigation

Zone 1 REBOA vs Resuscitative Thoracotomy for Patient Resuscitation After Severe Hemorrhagic Shock

Alexis L.聽Cralley,聽MD; Navin聽Vigneshwar,聽MD, MPH; Ernest E.聽Moore,聽MD; Joseph聽Dubose,聽MD; Megan L.聽Brenner,聽MD, MS; Angela聽Sauaia,聽MD, PhD; AAST AORTA Study Group; James聽Haan; Kelly聽Lightwine; Marko 聽Bukur; Matthew 聽Yanoff; Julie 聽Rizzo; Alexander 聽Beasy; Kevin 聽Chung; Matthew 聽Bloom; Jeannette G. 聽Ward; Joseph 聽Lachant; Nathaniel 聽Poulin; Afshin 聽Parsikia; Angela 聽Sauaia; Ernest 聽Moore; Kristin 聽Colling; Andrew W. 聽Kirkpatrick; Chad G.聽Ball; Zhengwen聽Xiao; Michelle 聽Mercado; Alma聽Rados; Chad聽Richardson; Derek聽Lumbard; Rachel聽Nygard; Forrest聽Moore; David聽Turay; Xian聽Luo-Owen; Alice聽Piccinini; Kenji聽Inaba; Laura J. 聽Moore; Seong聽Lee; Rachele聽Solomon; Joseph聽Farhat; Jesse聽Gibson; Sheldon 聽Teperman; M. Chance 聽Spalding; Timothy W.聽Wolff; Joseph聽Ibrahim; Karen Safcsak聽Safcsak; Juan聽Duchesne; Danielle聽Tatum; Catherine 聽Rauschendorfer ; Valorie L. 聽Baggenstoss; Gerry 聽Fortuna; Greg 聽Pinson; Robert M. 聽Madayag; Alyha 聽Benitez; Jeffrey聽Skubic; Monica M. 鈥嬄燘etancourt-Garcia; Elizabeth 聽Dauer; Jacob 聽Roden-Foreman; Sho Furuta聽Furuta; Karen 聽Ng; Michael聽Hayashi; Joseph聽Galante; Jay聽Doucet; Todd聽Constantini; Megan聽Brenner; Timothy聽Browder; Shahram聽Aarabi; David聽Skarupa; Jennifer A.聽Mull; Yohan 聽Diaz Zuniga; Rishi聽Kundi; Thomas M.聽Scalea; William 聽Teeter; Jeremy 聽Cannon; Mark 聽Seamon; Sarah聽Mathew; Brian聽Daley; Niki Rasnake聽Rasnake; Reagan聽Bollig; Eileen聽Bulger; Nam T. 聽Tran; Bradley 聽Dennis; Jennifer聽Knight; Nicole 聽Cornell; John K. 聽Bini; John 聽Matsuura; Joshua 聽Pringle; Kailey 聽Nolan; Karen 聽Herzing

JAMA Surgery

Nearly half of patients who arrive at US trauma centers with hemoperitoneum and hypotension and one-quarter of service members killed in combat die just from blood loss and hemorrhagic shock.¹^-3 The age-old, surgeon-centric approach of quickly getting to the operating room works for most but not all patients. These stubborn statistics, along with the evolution of less invasive endovascular techniques used for other conditions, have resulted in a reappraisal of resuscitative endovascular balloon occlusion of the aorta (REBOA).⁴

The emergence of REBOA has disrupted practice paradigms and been accompanied by calls for 鈥渉igh-quality鈥� data to prove its merit.⁴ Despite the known or empirical benefit of aortic occlusion to increase proximal pressure, decrease distal bleeding, and delay onset of a fatal dysrhythmia, skeptics and those unaccustomed to endovascular procedures have used the paucity of high-quality data to refute REBOA. Although the search for therapeutic evidence should remain a guiding principle, such high-quality data support very few of the lifesaving interventions performed during trauma resuscitations and emergent operations today.

糖心vlog

Object moved to here.

糖心vlog