REBOA (Resuscitative Endovascular Balloon Occlusion of the Aorta) im prähospitalen Einsatz – Präsentation zweier Fälle

Zusammenfassung

Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) ist ein wenig invasives Verfahren, um ein „internes“ Cross-Clamping der Aorta durchzuführen. Hierdurch ist es entweder möglich, den Blutverlust bei nicht komprimierbaren Körperstammblutungen zu reduzieren und den Patienten vor dem Verbluten zu retten oder im Rahmen der Herz-Lungen-Wiederbelebung (CPR) den koronaren und zerebralen Perfusionsdruck zu erhöhen und damit eventuell die ROSC-Rate und das neurologische Outcome zu verbessern. Aktuell findet REBOA in Deutschland nur in einigen Traumazentren im Schockraum Anwendung und der prähospitale Einsatz ist eher eine extrem seltene Ausnahme. Wir berichten über 2 Fälle, in denen das Verfahren im Rahmen des RIBCAP-HEMS-Projektes (REBOA In Bleeding and Cardiac Arrest in the Pre-hospital care by Helicopter Emergency Medical Service) prähospital durch das Team eines Rettungshubschraubers der DRF Luftrettung jeweils bei der CPR sowie beim Trauma angewendet wurde.

Abstract

Resuscitative endovascular balloon occlusion of the aorta (REBOA) is a less invasive procedure to perform an “internal” cross-clamping of the aorta. This allows either to reduce blood loss in non-compressible torso haemorrhage and to save the patient from bleeding to death or to increase coronary and cerebral perfusion pressure in the context of cardiopulmonary resuscitation and thus possibly improve the rate of return of spontaneous circulation and the neurological outcome. Currently, REBOA is used in Germany only in some trauma centres in the emergency room and the prehospital use is an extremely rare exception. We report two cases with prehospital application of the procedure by the team of a rescue helicopter of the DRF Luftrettung (German air rescue) in the context of the RIBCAP-HEMS project (REBOA In Bleeding and Cardiac Arrest in the Pre-hospital care by Helicopter Emergency Medical Service), respectively in CPR and in trauma.

Schlüsselwörter

Trauma - Kreislaufstillstand - REBOA - HEMS - Blutung - Wiederbelebung

Keywords

trauma - cardiac arrest - REBOA - HEMS - bleeding - resuscitation

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