Journal of Trauma and Injury

  • 제33권3호
  • /
  • Pages.170-174
  • /
  • 2020
  • /
  • 2799-4317(pISSN)
  • /
  • 2287-1683(eISSN)
대한외상학회 (The Korean Society of Traumatology)
권호 표지
DOI QR코드

DOI QR Code

Successful Damage Control Resuscitation with Resuscitative Endovascular Balloon Occlusion of the Aorta in a Pediatric Patient

  • Heo, Yoonjung (Department of Trauma Surgery, Trauma Center, Dankook University Hospital) ;
  • Chang, Sung Wook (Department of Thoracic and Cardiovascular Surgery, Trauma Center, Dankook University Hospital) ;
  • Kim, Dong Hun (Department of Trauma Surgery, Trauma Center, Dankook University Hospital)
  • 투고 : 2020.06.03
  • 심사 : 2020.07.17
  • 발행 : 2020.09.30
PDF 다운로드
⟨ 이전 논문 다음 논문 ⟩

초록

Resuscitative endovascular balloon occlusion of the aorta (REBOA) is considered an emerging adjunct therapy for profound hemorrhagic shock, as it can maintain temporary stability until definitive repair of the injury. However, there is limited information about the use of this procedure in children. Herein, we report a case of REBOA in a pediatric patient with blunt trauma, wherein the preoperative deployment of REBOA played a pivotal role in damage control resuscitation. A 7-year-old male patient experienced cardiac arrest after a motor vehicle accident. After 30 minutes of cardiopulmonary resuscitation, spontaneous circulation was achieved. The patient was diagnosed with massive hemoperitoneum. REBOA was then performed under ongoing resuscitative measures. An intra-aortic balloon catheter was deployed above the supraceliac aorta, which helped achieved permissive hypotension while the patient was undergoing surgery. After successful bleeding control with small bowel resection for mesenteric avulsion, thorough radiologic evaluations revealed hypoxic brain injury. The patient died from deterioration of disseminated intravascular coagulation. Although the patient did not survive, a postoperative computed tomography scan revealed neither remaining intraperitoneal injury nor peripheral ischemia correlated with the insertion of a 7-Fr sheath. Hence, REBOA can be a successful bridge therapy, and this result may facilitate the further usage of REBOA to save pediatric patients with non-compressible torso hemorrhage.

키워드

참고문헌

  1. Eastridge BJ, Holcomb JB, Shackelford S. Outcomes of traumatic hemorrhagic shock and the epidemiology of preventable death from injury. Transfusion 2019;59:1423-8. https://doi.org/10.1111/trf.15161
  2. Brenner M, Inaba K, Aiolfi A, DuBose J, Fabian T, Bee T, et al. Resuscitative endovascular balloon occlusion of the aorta and resuscitative thoracotomy in select patients with hemorrhagic shock: early results from the American Association for the Surgery of Trauma's Aortic Occlusion in resuscitation for trauma and acute care surgery registry. J Am Coll Surg 2018;226:730-40. https://doi.org/10.1016/j.jamcollsurg.2018.01.044
  3. Kim DH, Chang SW, Matsumoto J. The utilization of resuscitative endovascular balloon occlusion of the aorta: preparation, technique, and the implementation of a novel approach to stabilizing hemorrhage. J Thorac Dis 2018;10:5550-9. https://doi.org/10.21037/jtd.2018.08.71
  4. Brenner M, Bulger EM, Perina DG, Henry S, Kang CS, Rotondo MF, et al. Joint statement from the American College of Surgeons Committee on Trauma (ACS COT) and the American College of Emergency Physicians (ACEP) regarding the clinical use of resuscitative endovascular balloon occlusion of the aorta (REBOA). Trauma Surg Acute Care Open 2018;3:e000154. https://doi.org/10.1136/tsaco-2017-000154
  5. Campagna GA, Cunningham ME, Hernandez JA, Chau A, Vogel AM, Naik-Mathuria BJ. The utility and promise of resuscitative endovascular balloon occlusion of the aorta (REBOA) in the pediatric population: an evidence-based review. J Pediatr Surg 2020 Feb 1. doi: 10.1016/j.jpedsurg.2020.01.052 [Epub ahead of print].
  6. Sandgren T, Sonesson B, Ahlgren R, Lanne T. The diameter of the common femoral artery in healthy human: influence of sex, age, and body size. J Vasc Surg 1999;29:503-10. https://doi.org/10.1016/S0741-5214(99)70279-X
  7. Carrillo L, Skibber M, Kumar A, George M, Aziz S, T Harting M, et al. Morphometric and physiologic modeling study for endovascular occlusion in pediatric trauma patients. ASAIO J 2020;66:97-104. https://doi.org/10.1097/mat.0000000000000961
  8. Gandolfo F, Filippelli S, Cetrano E, Carotti A. Managing major vessel injuries with a Fogarty catheter during chest re-opening in children. Interact Cardiovasc Thorac Surg 2013;17:216-7. https://doi.org/10.1093/icvts/ivt084
  9. Black JJ, Allan A, Williams BT. The use of Foley balloon catheters in cardiac surgery. Eur J Cardiothorac Surg 1993;7:617-9. https://doi.org/10.1016/1010-7940(93)90251-6
  10. Hill SJ, Zarroug AE, Ricketts RR, Veeraswamy R. Bedside placement of an aortic occlusion balloon to control a ruptured aorto-esophageal fistula in a small child. Ann Vasc Surg 2010;24:822.e7-9.
  11. Kobayashi T, Matsuda K, Iwase F, Miyazaki Y, Amenomori S, Kikuchi H, et al. Blunt abdominal aortic injury in a child: a case report. Nihon Kyukyu Igakukai Zasshi 2010;21:343-50. https://doi.org/10.3893/jjaam.21.343