Safe and Effective Escalating Strategies to Treat Occult Non-Compressible Torso Hemorrhage
Abstract
Hemorrhage is associated with the majority of potentially survivable deaths on the battlefield. Most of these injuries are due to non-compressible torso hemorrhage (NCTH), which includes injuries to the lungs, solid organs, pelvis, and major blood vessels. Injuries at junctional sites, such as the neck, groin (inguinal), and underarm (axillary) areas, also contribute significantly to the total number of these injuries. Two methods of controlling pelvic and inguinal hemorrhage are the Abdominal Aortic and Junctional Tourniquet (AAJT) and Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA). The AAJT can be applied quickly, but prolonged use may damage the bowel, inhibit ventilation, and obstruct surgical access. REBOA requires technical proficiency, but has fewer complications. REBOA involves introducing a balloon catheter into the descending aorta in a specific occlusion region (Zone 1, 2, or 3) and acts as a hemorrhage control adjunct with resuscitative support. The balloon is placed in Zone 3 in the infrarenal aorta for high junctional or pelvic injuries and in Zone 1 proximal to the diaphragm for torso hemorrhage. Zone 1 REBOA provides more resuscitative support than Zone 3; however, the potential for ischemia and reperfusion injuries is greater with Zone 1 than with Zone 3 REBOA placement. This study aimed to determine the benefit and feasibility of transitioning from less invasive hemorrhage control adjuncts to more resource intensive interventions.
Document Details
- Document Type
- Technical Report
- Publication Date
- Apr 29, 2024
- Accession Number
- AD1227031
Entities
People
- Jason Rall
Organizations
- 59th Medical Wing