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Anesthetic Management of Patients After Traumatic Injury With Resuscitative Endovascular Balloon Occlusion of the Aorta

Engdahl, Ashton J. BA*; Parrino, Christopher R. BA*; Wasicek, Philip J. MD; Galvagno, Samuel M. Jr DO, PhD, MS, FCCM‡,§,‖; Brenner, Megan L. MD, MS, FACS; Anders, Megan G. MD, MS‡,‖; Conti, Bianca MD‡,§; Rock, Peter MD, MBA, FCCM‡,‖; McCunn, Maureen MD, MIPP, FCCM, FASA‡,§,‖

doi: 10.1213/ANE.0000000000004130
Trauma
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Resuscitative endovascular balloon occlusion of the aorta (REBOA) is a temporizing maneuver for noncompressible torso hemorrhage. To our knowledge, this single-center brief report provides the most extensive anesthetic data published to date on patients who received REBOA. As anticipated, patients were critically ill, exhibiting lactic acidosis, hypotension, hyperglycemia, hypothermia, and coagulopathy. All patients received blood products during their index operations and received less inhaled anesthetic gas than normally required for healthy patients of the same age. This study serves as an important starting point for clinician education and research into anesthetic management of patients undergoing REBOA.

From the *University of Maryland School of Medicine, Baltimore, Maryland

Departments of Surgery

Anesthesiology, University of Maryland School of Medicine, Baltimore, Maryland

§Division of Trauma Anesthesiology, R Adams Cowley Shock Trauma Center, Baltimore, Maryland

Division of Critical Care Anesthesiology, Department of Anesthesiology, University of Maryland School of Medicine, Baltimore, Maryland

Department of Surgery, University of California Riverside School of Medicine, Riverside, California.

Published ahead of print 2 August 2019.

Accepted for publication February 8, 2019.

Funding: This study was funded in part by a grant from the US Department of Defense titled “Clinical Study of Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) for Severe Pelvic Fracture & Intra-Abdominal Hemorrhagic Shock using Continuous Vital Signs” (grant No. W81XWH-15-1-0025).

Conflicts of Interest: See Disclosures at the end of the article.

A. J. Engdahl and C. R. Parrino contributed equally and share first authorship.

Reprints will not be available from the authors.

Address correspondence to Christopher R. Parrino, BA, University of Maryland School of Medicine, 655 W Baltimore St, Baltimore, MD 21201. Address e-mail to christopher.parrino@som.umaryland.edu.

Copyright © 2019 International Anesthesia Research Society
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