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Table 2 Hemorrhage control procedures and resuscitation parameters for blunt or non-thoracic, penetrating trauma patients undergoing zone 1 aortic occlusion via resuscitative thoracotomy versus resuscitative endovascular balloon occlusion of the aorta (REBOA)

From: Survival and neurologic outcomes following aortic occlusion for trauma and hemorrhagic shock in a hybrid operating room

Hemorrhage control and resuscitation

All patients (n = 26)

Resuscitative thoracotomy (n = 13)

REBOA (n = 13)

p

Initial aortic occlusion in ED

13 (50%)

11 (85%)

2 (15%)

 < 0.001

Initial aortic occlusion in OR

13 (50%)

2 (15%)

11 (85%)

 < 0.001

Other hemorrhage control procedures

    

  Heart laceration repair

2 (8%)

2(15%)

0 (0%)

0.480

  Pulmonary resection

1 (4%)

1 (8%)

0 (0%)

 > 0.999

  Lung laceration repair

3 (12%)

2 (15%)

1 (8%)

 > 0.999

  Solid organ resection

8 (31%)

2 (15%)

6 (46%)

0.202

  Solid organ repair

5 (19%)

2 (15%)

3 (23%)

 > 0.999

  Vascular bypass

1 (4%)

1 (8%)

0 (0%)

 > 0.999

  Primary repair of a named vessel

6 (23%)

2 (15%)

4 (31%)

0.645

  Ligation of a named vessel

4 (15%)

1 (8%)

3 (23%)

0.593

  Therapeutic angiographya

4 (15%)

0 (0%)

4 (31%)

0.096

Other adjunctive procedures

    

  Hollow viscous resection

2 (8%)

0 (0%)

2 (15%)

0.480

  Hollow viscous repair

2 (8%)

1 (8%)

1 (8%)

 > 0.999

  Diaphragm repair

1 (4%)

0 (0%)

1 (8%)

 > 0.999

CT or vascular surgery consultation

1 (4%)

1 (8%)

0 (0%)

 > 0.999

Interventional radiology consultation

4 (15%)

0 (0%)

4 (31%)

0.096

Obtained hemorrhage control in ORb

11 (42%)

1 (8%)

10 (77%)

0.001

Arrival to hemorrhage control (min)

111 [62–154]

62

112 [93–157]

0.343

OR start to hemorrhage control (min)

58 [32–91]

32

60 [33–103]

0.342

TXA administered 0–4 h after arrival

9 (35%)

5 (38%)

4 (31%)

 > 0.999

RBC transfusions 0–4 h after arrival

7.0 [4.0–14.8]

7.0 [5.5–13.5]

5.0 [4.0–17.5]

0.680

Plasma transfusions 0–4 h after arrival

6.0 [3.8–15.0]

7.0 [4.0–15.0]

4.0 [3.5–15.0]

0.718

RBC transfusions 4–24 h after arrival

2.0 [0.0–5.0]

0.0 [0.0–5.5]

2.0 [0.5–5.0]

0.397

Plasma transfusions 4–24 h after arrival

1.5 [0.0–5.0]

0.0 [0.0–4.5]

2.0 [0.0–5.5]

0.465

  1. ED, emergency department, REBOA, resuscitative endovascular balloon occlusion of the aorta, CT, presented as n (%) or median [interquartile range]. Cardiothoracic, IR, Interventional Radiology, TXA, tranexamic acid, RBC, red blood cell. Data are presented as n (%) or median [interquartile range]
  2. aEndovascular stent placement, balloon angioplasty, coil placement, or embolization. bSystolic blood pressure 100 mmHg or greater without ongoing vasopressor or blood product transfusion requirements or subsequent episodes of hypotension with systolic blood pressure less than 90 mmHg
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World Journal of Emergency Surgery

ISSN: 1749-7922