Is REBOA the Last Card to Control a Massive Gastrointestinal Bleeding?
J Surg Res
; 296: 735-741, 2024 Apr.
Article
en En
| MEDLINE
| ID: mdl-38368774
ABSTRACT
INTRODUCTION:
Resuscitative endovascular balloon occlusion of the aorta (REBOA) is a potential tool for the management of massive gastrointestinal bleeding (MGB). This study aims to describe the experience of the use of REBOA as adjunctive therapy in patients with MGB and to evaluate its effectiveness.METHODS:
Serial cases of patients with hemorrhagic shock secondary to MGB in whom REBOA was placed were collected. Patient demographics, bleeding severity, etiology, management, and clinical outcomes were recorded.RESULTS:
Between 2017 and 2020, five cases were analyzed. All patients had a severe gastrointestinal bleeding (Glasgow Blatchford Bleeding Score range 12-17; Clinical Rockal Score range 5-9). The etiologies of MGB were perforated gastric or duodenal ulcers, esophageal varices, and vascular lesions. Systolic blood pressure increased after REBOA placement and total occlusion time was 25-60 min. REBOA provided temporary hemorrhage control in all cases and allowed additional hemostatic maneuvers to be performed. Three patients survived more than 24 h. All patients died in index hospitalization. The main cause of death was related to hemorrhagic shock.CONCLUSIONS:
Endovascular aortic occlusion can work as a bridge to further resuscitation and attempts at hemostasis in patients with MGB. REBOA provides hemodynamic support and may be used simultaneously with other hemostatic maneuvers, facilitating definitive hemorrhage control.Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Choque Hemorrágico
/
Hemostáticos
/
Oclusión con Balón
/
Procedimientos Endovasculares
Límite:
Humans
Idioma:
En
Revista:
J Surg Res
Año:
2024
Tipo del documento:
Article
País de afiliación:
Colombia
Pais de publicación:
Estados Unidos