TY - JOUR
T1 - Quantifying the need for pediatric REBOA
T2 - a gap analysis
AU - Theodorou, Christina M.
AU - Trappey, A. Francois
AU - Beyer, Carl A.
AU - Yamashiro, Kaeli J.
AU - Hirose, Shinjiro
AU - Galante, Joseph M.
AU - Beres, Alana L.
AU - Stephenson, Jacob T.
N1 - Funding Information:
Funding Information: The project described was supported by the National Center for Advancing Translational Sciences, National Institutes of Health, through grant number UL1 TR001860 for author C.M.T. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH.
PY - 2020
Y1 - 2020
N2 - Background: Trauma is the leading cause of death in children. Resuscitative endovascular balloon occlusion of the aorta (REBOA) provides temporary hemorrhage control, but its potential benefit has not been assessed in children. We hypothesized that there are pediatric patients who may benefit from REBOA. Methods: Trauma patients < 18 years old at a level 1 pediatric trauma center between 2009 and 2019 were queried for deaths, pre-hospital cardiac arrest, massive transfusion protocol activation, transfusion requirement, or hemorrhage control surgery. These patients defined the cohort of severely injured patients. From this cohort, patients with intraabdominal injuries for which REBOA may provide temporary hemorrhage control were identified, including solid organ injury necessitating intervention, vascular injury, or pelvic hemorrhage. Results: There were 239 severely injured patients out of 6538 pediatric traumas. Of these, 38 had REBOA-amenable injuries (15.9%) with 34.2% mortality, accounting for 10.2% of all pediatric trauma deaths at one center. Eleven patients with REBOA-amenable injuries had TBI (28.9%). Patients with REBOA-amenable injuries represented 0.6% of all pediatric traumas. Conclusion: Nearly 20% of severely injured pediatric patients could potentially benefit from REBOA. The overall proportion of pediatric patients with REBOA-amenable injuries is similar to adult studies. Type of Study: Retrospective comparative study. Level of Evidence: Level III.
AB - Background: Trauma is the leading cause of death in children. Resuscitative endovascular balloon occlusion of the aorta (REBOA) provides temporary hemorrhage control, but its potential benefit has not been assessed in children. We hypothesized that there are pediatric patients who may benefit from REBOA. Methods: Trauma patients < 18 years old at a level 1 pediatric trauma center between 2009 and 2019 were queried for deaths, pre-hospital cardiac arrest, massive transfusion protocol activation, transfusion requirement, or hemorrhage control surgery. These patients defined the cohort of severely injured patients. From this cohort, patients with intraabdominal injuries for which REBOA may provide temporary hemorrhage control were identified, including solid organ injury necessitating intervention, vascular injury, or pelvic hemorrhage. Results: There were 239 severely injured patients out of 6538 pediatric traumas. Of these, 38 had REBOA-amenable injuries (15.9%) with 34.2% mortality, accounting for 10.2% of all pediatric trauma deaths at one center. Eleven patients with REBOA-amenable injuries had TBI (28.9%). Patients with REBOA-amenable injuries represented 0.6% of all pediatric traumas. Conclusion: Nearly 20% of severely injured pediatric patients could potentially benefit from REBOA. The overall proportion of pediatric patients with REBOA-amenable injuries is similar to adult studies. Type of Study: Retrospective comparative study. Level of Evidence: Level III.
KW - Gap analysis
KW - Pediatric REBOA
KW - Pediatric trauma
KW - REBOA
KW - Resuscitative endovascular balloon occlusion of the aorta
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U2 - 10.1016/j.jpedsurg.2020.09.011
DO - 10.1016/j.jpedsurg.2020.09.011
M3 - Article
C2 - 33046222
AN - SCOPUS:85092395071
JO - Journal of Pediatric Surgery
JF - Journal of Pediatric Surgery
SN - 0022-3468
ER -