PARTIAL OCCLUSION, LESS AKI: AN AORTA REGISTRY ANALYSIS OF PREBOA-PRO.

Publisher: Lippincott Williams & Wilkins Country of Publication: United States NLM ID: 9421564 Publication Model: Print Cited Medium: Internet ISSN: 1540-0514 (Electronic) Linking ISSN: 10732322 NLM ISO Abbreviation: Shock Subsets: MEDLINE

Publication: 2002- : Philadelphia : Lippincott Williams & Wilkins
Original Publication: Augusta, GA : BioMedical Press, [1994-

Acute Kidney Injury* ; Registries* ; Balloon Occlusion*/methods ; Aorta*/surgery; Humans ; Male ; Female ; Retrospective Studies ; Middle Aged ; Adult ; Hemorrhage ; Resuscitation/methods ; Aged ; Endovascular Procedures/methods

Abstract: Background: Noncompressible torso hemorrhage remains a leading cause of potentially preventable deaths. Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) has emerged as an adjunct temporizing hemorrhage control. The complete occlusion strategy with the ER-REBOA catheter can cause distal ischemia when used for longer than 30 min. To specifically address this limitation, the pREBOA-PRO catheter was developed. The objective of the current study is to investigate the impact of longer, partial occlusion times provided by pREBOA-PRO on acute kidney injury and mortality. Methods: This is a retrospective analysis of the Aortic Occlusion for Resuscitation in Trauma and Acute Care Surgery registry as of August 2023. Patients in the pREBOA-PRO group (n = 110) receiving partial occlusion in Zone 1 were contrasted to patients in the ER-REBOA group (n = 752) treated with complete occlusion in Zone 1. Between-group comparisons included demographics, clinical presentation, aortic occlusion strategy, clinical complications, and mortality. Results: Demographics, clinical presentation, and mortality were indistinguishable between groups, except for age which was higher in the ER-REBOA group (44 vs. 38, P < 0.002). The partial aortic occlusion strategy was employed more often in the pREBOA-PRO group (87% vs. 33%, P < 0.05) and for longer periods (59 min vs. 50 min, P < 0.003). In contrast, AKI occurred less frequently in the pREBOA-PRO group (19% vs. 33%, P < 0.05). Conclusions: The more frequently partial and longer occlusion times in Zone 1 with the use of pREBOA-PRO resulted in lower AKI incidence suggesting that this newer device is a safer extended bridge to hemorrhage control.
Competing Interests: The authors report no conflicts of interest.
(Copyright © 2024 by the Shock Society.)

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Date Created: 20241213 Date Completed: 20241213 Latest Revision: 20241216

20241217

10.1097/SHK.0000000000002500

39671549