Resuscitative endovascular balloon occlusion of the aorta (REBOA) is a minimally invasive procedure being increasingly utilized to prevent patients with non-compressible torso hemorrhage from exsanguination. The increased use of REBOA is giving rise to discussion about “Who is and who should be performing it?” Data from the international ABO (aortic balloon occlusion) Trauma Registry from between November 2014 and April 2020 were analyzed concerning the question: By who, how, and where is REBOA being performed? The registry collects retrospective and prospective data concerning use of REBOA in trauma patients. During the study period, 259 patients had been recorded in the registry, 72.5% (n = 188) were males with a median (range) age of 46 (10-96) years. REBOA was performed in the ER in 50.5%, in the OR in 41.5%, and in the angiography suite in 8% of patients. In 54% of the patients REBOA was performed by surgeons (trauma surgeons 28%, vascular surgeons 22%, general surgeons 4%) and in 46% of the patients by non-surgeons (emergency physicians 31%, radiologists 9.5%, anesthetists 5.5%). Common femoral artery (CFA) access was achieved by use of external anatomic landmarks and palpation alone in 119 patients (51%), by cutdown in 57 patients (24%), using ultrasound in 49 patients (21%), and by fluoroscopy in 9 patients (4%). Significant differences between surgeons and non-surgeons were found regarding patient’s age, injury severity, access methods, place where REBOA was performed, location patients were taken to from the emergency room, and mortality. A substantial number of both surgical and non-surgical medical disciplines are successfully performing REBOA to an almost equal extent. Surgical cutdown is used less frequently as access to the CFA compared with reports in older literature and puncture by use of external anatomic landmarks and palpation alone is used with a high rate of success. Instead of discussing “Who should be performing REBOA?” future research should focus on “Which patient benefits most from REBOA?”

中文翻译：

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成功的 REBOA 表现：医学专业重要吗？来自 ABOTrauma Registry 的国际数据

主动脉复苏性血管内球囊闭塞 (REBOA) 是一种微创手术，越来越多地用于防止不可压缩的躯干出血患者放血。越来越多地使用 REBOA 引发了关于“谁是谁以及谁应该执行它？”的讨论。2014 年 11 月至 2020 年 4 月期间，国际 ABO（主动脉球囊闭塞）创伤登记处的数据针对以下问题进行了分析：由谁、如何以及在何处执行 REBOA？该登记处收集有关在创伤患者中使用 REBOA 的回顾性和前瞻性数据。在研究期间，登记处记录了 259 名患者，其中 72.5%（n = 188）是男性，中位（范围）年龄为 46 (10-96) 岁。REBOA 在 ER 中进行了 50.5%，在 OR 中进行了 41.5%，8% 的患者在血管造影套件中。在 54% 的患者中，REBOA 由外科医生进行（创伤外科医生 28%，血管外科医生 22%，普通外科医生 4%）和 46% 的患者由非外科医生（急诊医生 31%，放射科医生 9.5%，麻醉师 5.5） %）。119 名患者 (51%) 仅通过使用外部解剖标志和触诊、57 名患者 (24%) 切开、49 名患者 (21%) 使用超声和透视法实现股总动脉 (CFA) 通路9 名患者 (4%)。发现外科医生和非外科医生在患者年龄、损伤严重程度、进入方法、执行 REBOA 的地点、患者从急诊室被带到的位置和死亡率方面存在显着差异。大量外科和非外科医学学科在几乎相同的程度上成功地执行了 REBOA。与较早的文献报道相比，手术切开较少使用作为获得 CFA 的途径，并且通过使用外部解剖标志和单独触诊进行穿刺的成功率很高。而不是讨论“谁应该执行 REBOA？” 未来的研究应该集中在“哪位患者从 REBOA 中获益最多？”