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The Use of a Urinary Balloon Catheter to Control Hemorrhage From Penetrating Torso Trauma: A Single-Center Experience at a Major Inner-City Hospital Trauma Center.

Authors
  • Himmler, Amber1, 2
  • Maria Calzetta, Ignacio Luis3
  • Potes, Andrea3
  • Puyana, Juan Carlos4
  • Barillaro, Guillermo Fabián3
  • 1 Department of Surgery, Medstar Georgetown University Hospital and Washington Hospital Center, Washington, DC, USA.
  • 2 University of Pittsburgh, Pittsburgh, PA, USA.
  • 3 Department of Surgery, Hospital Interzonal General de Agudos, Mar de Plata, Argentina. , (Argentina)
  • 4 6595 Department of Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
Type
Published Article
Journal
The American surgeon
Publication Date
Apr 01, 2021
Volume
87
Issue
4
Pages
543–548
Identifiers
DOI: 10.1177/0003134820949997
PMID: 33111566
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

Use of a urinary catheter balloon tamponade (UCBT) in controlling traumatic hemorrhage is a frequently employed but infrequently described technique. We aim to discuss the experience of balloon tamponade as a bridge to definitive hemorrhage control in the operating room. This is retrospective review at a single institution from January 2008 to December 2018. We identified patients with active bleeding from penetrating torso trauma in whom UCBT was used to tamponade bleeding. We used revised trauma score (RTS), injury severity score (ISS), and new trauma and injury severity score (TRISS) to quantify injury severity. All surviving patients required definitively hemorrhage control in the operating room. Primary endpoint was mortality at 24 hours and 30 days. Twenty-nine patients were managed with UCBT. Nine had hemorrhage controlled in the trauma bay, including 4 with neck trauma and 5 with cardiac trauma. Twenty patients had hemorrhage controlled in the operating room, including 15 with cardiac trauma and 5 with intra-abdominal hemorrhage. Mean RTS, ISS, and TRISS in this population were: 5.93, 19.31, and 83.78, respectively. Of the 9 patients treated in the trauma bay, 1 (11.1%) died in the first 24 hours and 2 died in the first 30 days (22.2%). Of the 20 patients treated in the operating room, 0 (0%) patients died in the first 24 hours and 3 died in the first 30 days (15.0%). UCBT is an effective tool that can be used to stabilize and bridge an actively bleeding patient to definitive hemorrhage control in the operating room.

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