Resuscitative Endovascular Balloon Occlusion of the Aorta: A Bridge to Flight Survival

Carl Goforth; Matthew Bradley; Benilani Pineda; Suzanne See; Jason Pasley

doi:10.4037/ccn2018853

Resuscitative Endovascular Balloon Occlusion of the Aorta: A Bridge to Flight Survival

Crit Care Nurse. 2018 Apr;38(2):69-75. doi: 10.4037/ccn2018853.

Authors

Carl Goforth^{1

2

3

4

5}, Matthew Bradley^{6

7

8

9

10}, Benilani Pineda^{6

7

8

9

10}, Suzanne See^{6

7

8

9

10}, Jason Pasley^{6

7

8

9

10}

Affiliations

¹ CDR Carl Goforth, NC, USN, is a nurse researcher, Naval Medical Research Center, Silver Spring, Maryland, and Uniformed Services University of the Health Sciences, Bethesda, Maryland. carl.w.goforth.mil@mail.mil.
² CDR Matthew Bradley, NC, USN, is a staff surgeon at Walter Reed National Military Medical Center, Bethesda, Maryland, and is conducting research on resuscitation at the Naval Medical Research Center, Silver Spring, Maryland. carl.w.goforth.mil@mail.mil.
³ MAJ Benilani Pineda, ANC, USA, is the former director, Joint En Route Care Course, Fort Rucker, Alabama. She is currently serving in the National Capital Region, US Army Executive Medicine, Washington, DC. carl.w.goforth.mil@mail.mil.
⁴ Maj Suzanne See, USAF, NC, is a trauma educator at the Center for the Sustainment of Trauma and Readiness Skills, R. Adams Crowley Shock Trauma Center, Baltimore, Maryland. carl.w.goforth.mil@mail.mil.
⁵ Lt Col Jason Pasley, USAF, MC, a board-certified trauma surgeon, is the director of physician education at the Center for the Sustainment of Trauma and Readiness Skills, R. Adams Crowley Shock Trauma Center. He also is a core faculty member of the American College of Surgeons basic endovascular skills for trauma course. carl.w.goforth.mil@mail.mil.
⁶ CDR Carl Goforth, NC, USN, is a nurse researcher, Naval Medical Research Center, Silver Spring, Maryland, and Uniformed Services University of the Health Sciences, Bethesda, Maryland.
⁷ CDR Matthew Bradley, NC, USN, is a staff surgeon at Walter Reed National Military Medical Center, Bethesda, Maryland, and is conducting research on resuscitation at the Naval Medical Research Center, Silver Spring, Maryland.
⁸ MAJ Benilani Pineda, ANC, USA, is the former director, Joint En Route Care Course, Fort Rucker, Alabama. She is currently serving in the National Capital Region, US Army Executive Medicine, Washington, DC.
⁹ Maj Suzanne See, USAF, NC, is a trauma educator at the Center for the Sustainment of Trauma and Readiness Skills, R. Adams Crowley Shock Trauma Center, Baltimore, Maryland.
¹⁰ Lt Col Jason Pasley, USAF, MC, a board-certified trauma surgeon, is the director of physician education at the Center for the Sustainment of Trauma and Readiness Skills, R. Adams Crowley Shock Trauma Center. He also is a core faculty member of the American College of Surgeons basic endovascular skills for trauma course.

PMID: 29606678
DOI: 10.4037/ccn2018853

Abstract

Trauma endures as the leading cause of death worldwide, and most deaths occur in the first 24 hours after initial injury as a result of hemorrhage. Historically, about 90% of battlefield deaths occur before the injured person arrives at a theater hospital, and most are due to noncompressible hemorrhage of the torso. Resuscitative endovascular balloon occlusion of the aorta is an evolving technique to quickly place a balloon into the thoracic or abdominal aorta to efficiently block blood flow to distal circulation. Maneuvers, such as resuscitative endovascular balloon occlusion of the aorta, to control endovascular hemorrhage offer a potential intervention to control noncompressible hemorrhage. This technique can be performed percutaneously or open in prehospital environments to restore hemodynamic functions and serve as a survival bridge until the patient is delivered to a treatment facility for definitive surgical hemostasis. This article describes the indications, complications, and application of resuscitative endovascular balloon occlusion of the aorta to military and civilian aeromedical transport.

MeSH terms

Adult
Aorta / injuries*
Aorta / surgery*
Balloon Occlusion / standards*
Endovascular Procedures / standards*
Female
Hemorrhage / surgery*
Humans
Male
Military Personnel
Patient Transfer / standards
Practice Guidelines as Topic
Resuscitation / standards*
War-Related Injuries / surgery*
Young Adult