A decade's experience with balloon catheter tamponade or the emergency control of hemorrhage

Chad G. Ball, Amy D. Wyrzykowski, Jeffrey M. Nicholas, Grace Rozycki, David V. Feliciano

Research output: Contribution to journalArticle

Abstract

Background: Balloon catheter tamponade is a valuable technique for arresting exsanguinating hemorrhage. Indications include (1) inaccessible major vascular injuries, (2) large cardiac injuries, and (3) deep solid organ parenchymal bleeding. Published literature is limited to small case series. The primary goal was to review a recent experience with balloon catheter use for emergency tamponade in a civilian trauma population. Methods: All patients requiring emergency use of a balloon catheter to tamponade exsanguinating hemorrhage (1998-2009) were included. Patient demographics, injury characteristics, technique, and outcomes were analyzed. Results: Of the 44 severely injured patients (82% presented with hemodynamic instability; mean base deficit = -20.4) who required balloon catheter tamponade, 23 of the balloons (52%) remained indwelling for more than 6 hours. Overall mortality depended on the site of injury/catheter placement and indwelling time (81% if <6 hours; 52% if ≥6 hours; p < 0.05). Physiologic exhaustion was responsible for 76% of deaths in patients with short-term balloons. Mortality among patients with prolonged balloon catheter placement was 11%, 50%, and 88% for liver, abdominal vascular, and facial/pharyngeal injuries, respectively. Mean indwelling times for iliac, liver, and carotid injuries were 31 hours, 53 hours, and 78 hours, respectively. Overall survival rates were 67% (liver), 67% (extremity vascular), 50% (abdominal vascular), 38% (cardiac), and 8% (face). Techniques included Foley, Fogarty, Blakemore, and/or Penrose drains with concurrent red rubber Robinson catheters. Initial tamponade of bleeding structures was successful in 93% of patients. Conclusion: Balloon catheter tamponade can be used in multiple anatomic regions and for variable patterns of injury to arrest ongoing hemorrhage. Placement for central hepatic gunshot wounds is particularly useful. This technique remains a valuable tool in a surgeon's armamentarium.

Original languageEnglish (US)
Pages (from-to)330-333
Number of pages4
JournalJournal of Trauma - Injury, Infection and Critical Care
Volume70
Issue number2
DOIs
StatePublished - Feb 1 2011
Externally publishedYes

Fingerprint

Balloon Occlusion
Emergencies
Catheters
Hemorrhage
Wounds and Injuries
Exsanguination
Blood Vessels
Liver
Facial Injuries
Gunshot Wounds
Indwelling Catheters
Mortality
Vascular System Injuries
Rubber
Survival Rate
Extremities
Hemodynamics
Demography
Population

Keywords

  • Balloon catheter tamponade
  • Damage control
  • Hemorrhage

ASJC Scopus subject areas

  • Surgery
  • Critical Care and Intensive Care Medicine

Cite this

A decade's experience with balloon catheter tamponade or the emergency control of hemorrhage. / Ball, Chad G.; Wyrzykowski, Amy D.; Nicholas, Jeffrey M.; Rozycki, Grace; Feliciano, David V.

In: Journal of Trauma - Injury, Infection and Critical Care, Vol. 70, No. 2, 01.02.2011, p. 330-333.

Research output: Contribution to journalArticle

Ball, Chad G. ; Wyrzykowski, Amy D. ; Nicholas, Jeffrey M. ; Rozycki, Grace ; Feliciano, David V. / A decade's experience with balloon catheter tamponade or the emergency control of hemorrhage. In: Journal of Trauma - Injury, Infection and Critical Care. 2011 ; Vol. 70, No. 2. pp. 330-333.
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