Quantifying the need for pediatric REBOA: a gap analysis
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Read the article on jpedsurg.org ↗Article · Oct 2020 · 1 min read
In brief
In brief
Retrospective study of 6,538 pediatric trauma cases found that nearly 20% of severely injured children had injuries potentially amenable to REBOA for temporary hemorrhage control, with mortality of 34.2% in this subset. The proportion of pediatric patients with REBOA-amenable injuries (0.6%) mirrors adult trauma populations, supporting consideration of this technique in pediatric resuscitation protocols.
Written by the GCMD Library team from the article.
Abstract
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.