Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) for Severe Torso Trauma in Japan: A Descriptive Study
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Resuscitative endovascular balloon occlusion of the aorta (REBOA) has the potential to be an alternative to open aortic cross-clamping (ACC). However, its practical indication remains unknown. We examined the usage trend of REBOA and ACC in Japan for severe torso trauma and investigated whether these procedures were associated with the time of death distribution based on a large database from the Japan Trauma Data Bank (JTDB).
The JTDB from 2004 to 2014 was reviewed. Eligible patients were restricted to those with severe torso trauma, which was defined as an abbreviated injury scale score of ≥4. Patients were classified into groups according to the aortic occlusion procedures. The primary outcomes were the rates of REBOA and ACC use according to the clinical situation. We also evaluated whether the time of death distribution for the first 8 h differed based on these procedures.
During the study period, a total of 21,533 patients met our inclusion criteria. Overall, REBOA was more commonly used than ACC for patients with severe torso trauma (2.8% vs 1.5%). However, ACC was more frequently used in cases of thoracic injury and cardiac arrest. Regarding the time of death distribution, the cumulative curve for death in REBOA cases was elevated much more slowly and mostly flat for the first 100 min.
REBOA is more commonly used compared to ACC for patients with severe torso trauma in Japan. Moreover, it appears that REBOA influences the time of death distribution in the hyperacute phase.
SM, TA, TF, and KJ participated in the study design. SM and KH participated in the analysis and interpretation of data. SM and KS participated in drafting the article. TM critically revised the manuscript.
Compliance with ethical standards
Conflicts of interest
The authors declare that there is no conflict of interest.
- 2.Pasley J, Cannon J, Glaser J, Polk T et al. (2017) Joint trauma system clinical practice guideline (JTS CPG), resuscitative endovascular balloon occlusion of the aorta (REBOA) for hemorrhagic shock (CPG ID: 38). http://prytimemedical.com/wp-content/uploads/2017/07/REBOA_-CPG_FINAL.pdf. Accessed 14 Dec 2018