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Notfall + Rettungsmedizin

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02.01.2018 | Leitthema

REBOA (Resuscitative Endovascular Balloon Occlusion of the Aorta)

Brauchen wir das wirklich?

verfasst von: M. Wortmann, K. Elias, S. Zerwes, D. Böckler, Prof. Dr. A. Hyhlik-Dürr

Erschienen in: Notfall + Rettungsmedizin | Ausgabe 2/2019

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Zusammenfassung

Hintergrund

Nichtkomprimierbare Blutungen des Körperstamms stellen eine der Haupttodesursachen traumatisierter Patienten, sowohl im militärischen als auch im zivilen Bereich, dar.

Ziel

Die REBOA-Technik (REBOA Resuscitative Endovascular Balloon Occlusion of the Aorta), mögliche Einsatzgebiete, potenzielle Komplikationen und die Frage nach der Relevanz im Alltag des Notfallmediziners sollen erläutert werden.

Material und Methode

Beschreibung bisheriger Einsatzgebiete von REBOA, Auswertung der aktuellen Studienlage, Diskussion der praktischen Anwendung.

Ergebnisse

Im Rahmen der „Damage Control“ wird ein über die Leistenarterien eingebrachter Ballon proximal der vermuteten Blutungsquelle in der Aorta platziert, um damit ein Verbluten des Patienten zu verhindern und eine weitere Versorgung durchführen zu können. Die aktuelle Studienlage zeigt, dass REBOA in den meisten Fällen zu einer Verbesserung des systolischen Blutdrucks sowie des mittleren arteriellen Blutdrucks und zu einer Reduktion der Herzfrequenz führt. Eine Reduktion der blutungsassoziierten Mortalität konnte bislang jedoch noch nicht sicher gezeigt werden.

Schlussfolgerungen

Aufgrund der möglichen Komplikationen während und nach der REBOA-Prozedur ist eine gefäßchirurgische Expertise unabdingbar. Zudem sind wegen der geringen Fallzahlen sowohl anfängliche Schulungen als auch regelmäßige Übungen notwendig. Dennoch stellt REBOA eine potenziell lebensrettende Sofortmaßnahme dar, die als solche im Portfolio von Traumazentren vorgehalten werden sollte.

Vorheriger Artikel Invasive Notfalltechniken – INTECH Advanced

Nächster Artikel Notfallkoniotomie – chirurgisch oder doch Punktion?

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Titel: REBOA (Resuscitative Endovascular Balloon Occlusion of the Aorta)
Brauchen wir das wirklich?
verfasst von: M. Wortmann
K. Elias
S. Zerwes
D. Böckler
Prof. Dr. A. Hyhlik-Dürr
Publikationsdatum: 02.01.2018
Verlag: Springer Medizin
Erschienen in: Notfall + Rettungsmedizin / Ausgabe 2/2019
Print ISSN: 1434-6222
Elektronische ISSN: 1436-0578
DOI: https://doi.org/10.1007/s10049-017-0396-1

Springerpflege

Zusammenfassung

Hintergrund

Ziel

Material und Methode

Ergebnisse

Schlussfolgerungen

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