RT Journal Article
SR Electronic
T1 Systematic review to evaluate algorithms for REBOA use in trauma and identify a consensus for patient selection
JF Trauma Surgery & Acute Care Open
JO Trauma Surg Acute Care Open
FD BMJ Publishing Group Ltd
SP e000984
DO 10.1136/tsaco-2022-000984
VO 7
IS 1
A1 Amelia Walling Maiga
A1 Rishi Kundi
A1 Jonathan James Morrison
A1 Chance Spalding
A1 Juan Duchesne
A1 John Hunt
A1 Jonathan Nguyen
A1 Elizabeth Benjamin
A1 Ernest E Moore
A1 Ryan Lawless
A1 Andrew Beckett
A1 Rachel Russo
A1 Bradley M Dennis
YR 2022
UL http://tsaco.bmj.com/content/7/1/e000984.abstract
AB Background Patient selection for resuscitative endovascular balloon occlusion of the aorta (REBOA) has evolved during the last decade. A recent multicenter collaboration to implement the newest generation REBOA balloon catheter identified variability in patient selection criteria. The aims of this systematic review were to compare recent REBOA patient selection guidelines and to identify current areas of consensus and variability.Methods In accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, we conducted a systematic review of clinical practice guidelines for REBOA patient selection in trauma. Published algorithms from 2015 to 2022 and institutional guidelines from a seven-center REBOA collaboration were compiled and synthesized.Results Ten published algorithms and seven institutional guidelines on REBOA patient selection were included. Broad consensus exists on REBOA deployment for blunt and penetrating trauma patients with non-compressible torso hemorrhage refractory to blood product resuscitation. Algorithms diverge on precise systolic blood pressure triggers for early common femoral artery access and REBOA deployment, as well as the use of REBOA for traumatic arrest and chest or extremity hemorrhage control.Conclusion Although our convenience sample of institutional guidelines likely underestimates patient selection variability, broad consensus exists in the published literature regarding REBOA deployment for blunt and penetrating trauma patients with hypotension not responsive to resuscitation. Several areas of patient selection variability reflect individual practice environments.Level of evidence Level 5, systematic review.