Nationwide use of REBOA in adolescent trauma patients: An analysis of the AAST AORTA registry

AAST AORTA Study Group

Research output: Contribution to journalArticlepeer-review

8 Scopus citations

Abstract

Background: Trauma is the leading cause of death for children and adolescents. Resuscitative endovascular balloon occlusion of the aorta (REBOA) is a minimally invasive method of hemorrhage control used primarily in adults. We aimed to characterize REBOA use in pediatric patients. Methods: The American Association for the Surgery of Trauma (AAST) Aortic Occlusion for Resuscitation in Trauma and Acute Care Surgery (AORTA) registry was queried for patients <18 years old undergoing REBOA placement (2013-2020). The primary outcome was mortality. Secondary outcomes included injury severity score (ISS), additional interventions, and complications. Results: Eleven patients with a median age of 17 years old had REBOA placed, with a survival rate of 30%. Inflation of the REBOA balloon resulted in a significant increase in systolic blood pressure (SBP) (median SBP pre-REBOA 53 mmHg vs. post-REBOA 110 mmHg, p=0.0007). Patients were severely injured with a median ISS of 29 (interquartile range 16-42). There were no access-site complications. All three surviving patients had a discharge Glasgow Coma Scale of 15. Conclusion: REBOA is used in patients <18 years old, but all reported patients in this registry were adolescents. No REBOA-related complications were reported. Identifying pediatric patients who may benefit from REBOA and modifying currently existing technology for this group of patients is an area of ongoing research.

Original languageEnglish
Pages (from-to)2512-2516
Number of pages5
JournalInjury
Volume51
Issue number11
DOIs
StatePublished - Nov 2020
Externally publishedYes

Keywords

  • Pediatric trauma
  • REBOA
  • Resuscitative endovascular balloon occlusion of the aorta

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