A meta-analysis of resuscitative endovascular balloon occlusion of the aorta (REBOA) or open aortic cross-clamping by resuscitative thoracotomy in non-compressible torso hemorrhage patients

Authors

Ramiro Manzano Nunez, Fundación Valle del Lili
Maria Paula Naranjo, Fundación Valle del Lili
Esteban Foianini, Clinical Foianini
Paula Ferrada, Virginia Commonwealth University
Erika Rincon, Fundación Valle del Lili
Herney Andrés García-Perdomo, Universidad del Valle
Paola Burbano, Universidad Javeriana Cali
Juan Pablo Herrera, Brigham and Women’s Hospital
Alberto F. García, Universidad del Valle, Fundación Valle del Lili
Carlos A. Ordoñez, Universidad del Valle, Fundación Valle del Lili

Document Type

Article

Original Publication Date

2017

Journal/Book/Conference Title

World Journal of Emergency Surgery

Volume

12

Issue

30

First Page

1

Last Page

9

DOI of Original Publication

10.1186/s13017-017-0142-5

Comments

Originally published at https://doi.org/10.1186/s13017-017-0142-5

Date of Submission

August 2017

Abstract

Background

The objective of this systematic review and meta-analysis was to determine the effect of REBOA, compared to resuscitative thoracotomy, on mortality and among non-compressible torso hemorrhage trauma patients.

Methods

Relevant articles were identified by a literature search in MEDLINE and EMBASE. We included studies involving trauma patients suffering non-compressible torso hemorrhage. Studies were eligible if they evaluated REBOA and compared it to resuscitative thoracotomy. Two investigators independently assessed articles for inclusion and exclusion criteria and selected studies for final analysis. We conducted meta-analysis using random effect models.

Results

We included three studies in our systematic review. These studies included a total of 1276 patients. An initial analysis found that although lower in REBOA-treated patients, the odds of mortality did not differ between the compared groups (OR 0.42; 95% CI 0.17–1.03). Sensitivity analysis showed that the risk of mortality was significantly lower among patients who underwent REBOA, compared to those who underwent resuscitative thoracotomy (RT) (RR 0.81; 95% CI 0.68–0.97).

Conclusion

Our meta-analysis, mainly from observational data, suggests a positive effect of REBOA on mortality among non-compressible torso hemorrhage patients. However, these results deserve further investigation.

Rights

© The Author(s). 2017 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

Is Part Of

VCU Surgery Publications