Preprint Case Report Version 1 This version is not peer-reviewed

Use of REBOA in a Zone Trauma Center Emergency Department for the Management of Massive Hemorrhage Secondary to Major Trauma, with Subsequent Transfer to a Level 1 Trauma Center for Surgery after Hemodynamic Stabilization

Version 1 : Received: 11 October 2024 / Approved: 14 October 2024 / Online: 14 October 2024 (16:30:46 CEST)

How to cite: Cappellini, I.; Baldini, A.; Baraghini, M.; Bartolucci, M.; Cantafio, S.; Crocco, A.; Zini, M.; Magazzini, S.; Menici, F.; Pavoni, V.; Lai, F. Use of REBOA in a Zone Trauma Center Emergency Department for the Management of Massive Hemorrhage Secondary to Major Trauma, with Subsequent Transfer to a Level 1 Trauma Center for Surgery after Hemodynamic Stabilization. Preprints 2024, 2024101088. https://doi.org/10.20944/preprints202410.1088.v1 Cappellini, I.; Baldini, A.; Baraghini, M.; Bartolucci, M.; Cantafio, S.; Crocco, A.; Zini, M.; Magazzini, S.; Menici, F.; Pavoni, V.; Lai, F. Use of REBOA in a Zone Trauma Center Emergency Department for the Management of Massive Hemorrhage Secondary to Major Trauma, with Subsequent Transfer to a Level 1 Trauma Center for Surgery after Hemodynamic Stabilization. Preprints 2024, 2024101088. https://doi.org/10.20944/preprints202410.1088.v1

Abstract

Background: Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) is an emerging technique in trauma care for managing severe hemorrhage when conventional resuscitation is inadequate. Methods: We report a case involving a 45 yo female patient who sustained multiple traumatic injuries—including thoracic, pelvic, and aortic damage—after a fall from approximately 5 meters. The timely insertion of a REBOA device provided critical hemodynamic support, allowing for temporary stabilization in the emergency department according to the principles of Damage Control Resuscitation. Results: This intervention facilitated her subsequent transfer to a Level 1 Trauma Center for definitive surgical intervention.Although the patient's prognosis remained poor due to the severity of her injuries, the use of REBOA illustrated its potential utility in improving hemodynamic stability in critically injured patients. Conclusions: Our findings suggest that REBOA can be a valuable adjunct in trauma management, offering a life-saving option in critical hemorrhagic cases where traditional methods are insufficient. Further research is warranted to refine REBOA application, particularly concerning optimal balloon positioning and integration with imaging techniques.

Keywords

Major bleeding; Major trauma; REBOA; haemodynamic stabilization

Subject

Medicine and Pharmacology, Emergency Medicine

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