APSA Article of Interest: REBOA in Pediatric Trauma
Timestops (8)
Tools Used
Topic Overview
Key Takeaways
- REBOA use in pediatric trauma is extremely rare: only 11 patients <18 years documented in AAST registry over 7 years, all adolescents.
- REBOA improved hemodynamics in pediatric cases but mortality remained high with only 30% survival rate.
- Barriers to pediatric REBOA adoption include need for device modifications and lack of clear patient selection criteria.
- REBOA involves femoral arterial access with balloon occlusion of aorta in zones 1-3 for hemorrhage control in trauma.
- Technology gaining traction in adult trauma centers but not yet standard practice in pediatric population.
Keywords
Hashtags
Transcript
This is Britney Levy from Stay Current, and I'm back with an ApSa Article of Interest that you should know. So today, we're going to talk about REBOA in kids. So REBOA isn't used at all centers even in adults. So as a reminder, REBOA stands for resuscitative endovascular balloon occlusion of the aorta. And it's a minimally invasive method of hemorrhage control where a sheath is introduced into the aorta via femoral arterial access. And it's inflated to occlude the arterial flow in either zone one, two, or three of the thoracic or abdominal aorta. So REBOA has been gaining popularity for trauma and non-trauma indications in adult centers. And so these authors queried the American Association for the Surgery of Trauma, the AAST, REBOA registry for pediatric patients to see how or if it's being used in pediatrics. And so here's the deal. Over seven years time, there were only 11 patients in the registry that were less than 18 years old that had a REBOA placed, all of which were adolescents and they had a median age of 17. The REBOA did improve hemodynamics in this population, but still only 30% survived. So overall, REBOA hasn't made it into prime time for pediatric trauma yet. And that might be due to a few reasons. The technology might need some modifications for pediatric use, and we might need a better identification strategy to know what patients would benefit from REBOA intervention at all. Are you all using REBOA in kids or adults at your center? Leave us a comment below and check out the Stay Current app for more articles that you should know.