Implementation of resuscitative XXXX of the aorta as an alternative to resuscitative thoracotomy for noncompressible @entity548 .

@entity1 @entity548 @entity138 @entity432 @entity204 @entity130
BACKGROUND: @entity548 remains the leading cause of @entity204 in @entity130 @entity1 . Proximal @entity432 , usually performed by direct aortic cross-clamping via thoracotomy, can provide temporary hemodynamic stability, permitting @entity130 repair. Resuscitative @entity432 of the aorta (REBOA) uses a minimally invasive, transfemoral balloon catheter, which is rapidly inserted retrograde and inflated for @entity432 , and may control inflow and allow time for hemostasis. We compared resuscitative thoracotomy with aortic cross-clamping ( @entity138 ) with REBOA in @entity130 @entity1 in profound @entity548 . METHODS: @entity130 registry data was used to compare all @entity1 undergoing @entity138 or REBOA during an 18-month period from two Level 1 @entity130 centers. RESULTS: There was no difference between @entity138 (n = 72) and REBOA groups (n = 24) in terms of demographics, mechanism of injury, or Injury Severity Scores (ISSs). There was no difference in chest and abdominal @entity130 ( @entity130 ) scores between the groups. However, the @entity138 @entity1 had lower extremity @entity130 score as compared with REBOA @entity1 (1.5 [0-3] vs. 4 [3-4], p < 0.001). Of the 72 @entity138 @entity1 , 45 (62.5%) died in the emergency department, 6 (8.3%) died in the operating room, and 14 (19.4%) died in the intensive care unit. Of the 24 REBOA @entity1 , 4 (16.6%) died in the emergency department, 3 (12.5%) died in the operating room, and 8 (33.3%) died in the intensive care unit. In comparing location of @entity204 between the @entity138 and REBOA groups, there were a significantly higher number of @entity204 in the emergency department among the @entity138 @entity1 as compared with the REBOA @entity1 (62.5% vs. 16.7%, p < 0.001). REBOA had fewer early @entity204 and improved overall survival as compared with @entity138 (37.5% vs. 9.7%, p = 0.003). CONCLUSION: REBOA is feasible and controls noncompressible @entity548 in @entity130 @entity1 in profound shock. @entity1 undergoing REBOA have improved overall survival and fewer early @entity204 as compared with @entity1 undergoing @entity138 . LEVEL OF EVIDENCE: Therapeutic study, level IV.
