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Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) in Non-Traumatic Cardiac Arrest: A Narrative Review of Known and Potential Physiological Effects

Resuscitative endovascular balloon occlusion of the aorta (REBOA) is widely used in acute trauma care worldwide and has recently been proposed as an adjunct to standard treatments during cardiopulmonary resuscitation in patients with non-traumatic cardiac arrest (NTCA). Several case series have been...

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Autores principales: Mazzoli, Carlo Alberto, Chiarini, Valentina, Coniglio, Carlo, Lupi, Cristian, Tartaglione, Marco, Gamberini, Lorenzo, Semeraro, Federico, Gordini, Giovanni
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8836569/
https://www.ncbi.nlm.nih.gov/pubmed/35160193
http://dx.doi.org/10.3390/jcm11030742
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author Mazzoli, Carlo Alberto
Chiarini, Valentina
Coniglio, Carlo
Lupi, Cristian
Tartaglione, Marco
Gamberini, Lorenzo
Semeraro, Federico
Gordini, Giovanni
author_facet Mazzoli, Carlo Alberto
Chiarini, Valentina
Coniglio, Carlo
Lupi, Cristian
Tartaglione, Marco
Gamberini, Lorenzo
Semeraro, Federico
Gordini, Giovanni
author_sort Mazzoli, Carlo Alberto
collection PubMed
description Resuscitative endovascular balloon occlusion of the aorta (REBOA) is widely used in acute trauma care worldwide and has recently been proposed as an adjunct to standard treatments during cardiopulmonary resuscitation in patients with non-traumatic cardiac arrest (NTCA). Several case series have been published highlighting promising results, and further trials are starting. REBOA during CPR increases cerebral and coronary perfusion pressure by increasing the afterload of the left ventricle, thus improving the chances of ROSC and decreasing hypoperfusion to the brain. In addition, it may facilitate the termination of malignant arrhythmias by stimulating baroreceptor reflex. Aortic occlusion could mitigate the detrimental neurological effects of adrenaline, not only by increasing cerebral perfusion but also reducing the blood dilution of the drug, allowing the use of lower doses. Finally, the use of a catheter could allow more precise hemodynamic monitoring during CPR and a faster transition to ECPR. In conclusion, REBOA in NTCA is a feasible technique also in the prehospital setting, and its use deserves further studies, especially in terms of survival and good neurological outcome, particularly in resource-limited settings.
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spelling pubmed-88365692022-02-12 Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) in Non-Traumatic Cardiac Arrest: A Narrative Review of Known and Potential Physiological Effects Mazzoli, Carlo Alberto Chiarini, Valentina Coniglio, Carlo Lupi, Cristian Tartaglione, Marco Gamberini, Lorenzo Semeraro, Federico Gordini, Giovanni J Clin Med Review Resuscitative endovascular balloon occlusion of the aorta (REBOA) is widely used in acute trauma care worldwide and has recently been proposed as an adjunct to standard treatments during cardiopulmonary resuscitation in patients with non-traumatic cardiac arrest (NTCA). Several case series have been published highlighting promising results, and further trials are starting. REBOA during CPR increases cerebral and coronary perfusion pressure by increasing the afterload of the left ventricle, thus improving the chances of ROSC and decreasing hypoperfusion to the brain. In addition, it may facilitate the termination of malignant arrhythmias by stimulating baroreceptor reflex. Aortic occlusion could mitigate the detrimental neurological effects of adrenaline, not only by increasing cerebral perfusion but also reducing the blood dilution of the drug, allowing the use of lower doses. Finally, the use of a catheter could allow more precise hemodynamic monitoring during CPR and a faster transition to ECPR. In conclusion, REBOA in NTCA is a feasible technique also in the prehospital setting, and its use deserves further studies, especially in terms of survival and good neurological outcome, particularly in resource-limited settings. MDPI 2022-01-29 /pmc/articles/PMC8836569/ /pubmed/35160193 http://dx.doi.org/10.3390/jcm11030742 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Review
Mazzoli, Carlo Alberto
Chiarini, Valentina
Coniglio, Carlo
Lupi, Cristian
Tartaglione, Marco
Gamberini, Lorenzo
Semeraro, Federico
Gordini, Giovanni
Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) in Non-Traumatic Cardiac Arrest: A Narrative Review of Known and Potential Physiological Effects
title Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) in Non-Traumatic Cardiac Arrest: A Narrative Review of Known and Potential Physiological Effects
title_full Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) in Non-Traumatic Cardiac Arrest: A Narrative Review of Known and Potential Physiological Effects
title_fullStr Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) in Non-Traumatic Cardiac Arrest: A Narrative Review of Known and Potential Physiological Effects
title_full_unstemmed Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) in Non-Traumatic Cardiac Arrest: A Narrative Review of Known and Potential Physiological Effects
title_short Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) in Non-Traumatic Cardiac Arrest: A Narrative Review of Known and Potential Physiological Effects
title_sort resuscitative endovascular balloon occlusion of the aorta (reboa) in non-traumatic cardiac arrest: a narrative review of known and potential physiological effects
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8836569/
https://www.ncbi.nlm.nih.gov/pubmed/35160193
http://dx.doi.org/10.3390/jcm11030742
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