Sean Hurley1, Mete Erdogan2, Jacinthe Lampron3, Robert S Green4,5,6. 1. Department of Emergency Medicine, Dalhousie University, Halifax, NS, Canada. 2. Nova Scotia Health Trauma Program, Nova Scotia Health, Halifax, NS, Canada. 3. Department of Surgery, University of Ottawa, Ottawa, ON, Canada. 4. Department of Emergency Medicine, Dalhousie University, Halifax, NS, Canada. greenrs@dal.ca. 5. Nova Scotia Health Trauma Program, Nova Scotia Health, Halifax, NS, Canada. greenrs@dal.ca. 6. Department of Critical Care, Dalhousie University, Halifax, NS, Canada. greenrs@dal.ca.
Abstract
OBJECTIVE: To determine how many Level 1 and Level 2 trauma centres in Canada have implemented a resuscitative endovascular balloon occlusion of the aorta (REBOA) program, and to identify facilitators and barriers to successful implementation of REBOA programs. METHODS: An electronic survey was developed and administered in November 2019 (updated in July 2021) via email to directors at all 32 Level 1 and Level 2 trauma centres across Canada, and to the medical director in PEI (no Level 1 or Level 2 capacity). Survey responses were supplemented by an online search in PubMed and the grey literature. Responses were analyzed using simple descriptive statistics including frequencies and proportions. RESULTS: We received responses from directors at 22 sites (17 Level 1 trauma centres, 4 Level 2 trauma centres, PEI) for a response rate of 66.7%. There are 6 Level 1 trauma centres with REBOA programs; all were implemented between 2017 and 2019. One additional Level 1 trauma centre that did not respond was found to have a REBOA program; thus, 21.9% (7/32) of Canadian Level 1 and Level 2 trauma centres have an existing REBOA program. These programs are located in three provinces (British Columbia, Ontario, Quebec). Five other centres are planning on implementing a REBOA program in the next 2 years. The number of REBOA cases performed ranged from 0 to 30 (median 2). Factors contributing most to successful program implementation were having physician champions and patient populations with sufficient REBOA candidates, while cost and lack of expertise were the greatest barriers identified. CONCLUSION: As of July 2021, 21.9% (7/32) of Canadian Level 1 and Level 2 trauma centres have a REBOA program. Physician champions and a patient population with sufficient numbers of REBOA candidates were the most important factors contributing to successful implementation of these programs.
OBJECTIVE: To determine how many Level 1 and Level 2 trauma centres in Canada have implemented a resuscitative endovascular balloon occlusion of the aorta (REBOA) program, and to identify facilitators and barriers to successful implementation of REBOA programs. METHODS: An electronic survey was developed and administered in November 2019 (updated in July 2021) via email to directors at all 32 Level 1 and Level 2 trauma centres across Canada, and to the medical director in PEI (no Level 1 or Level 2 capacity). Survey responses were supplemented by an online search in PubMed and the grey literature. Responses were analyzed using simple descriptive statistics including frequencies and proportions. RESULTS: We received responses from directors at 22 sites (17 Level 1 trauma centres, 4 Level 2 trauma centres, PEI) for a response rate of 66.7%. There are 6 Level 1 trauma centres with REBOA programs; all were implemented between 2017 and 2019. One additional Level 1 trauma centre that did not respond was found to have a REBOA program; thus, 21.9% (7/32) of Canadian Level 1 and Level 2 trauma centres have an existing REBOA program. These programs are located in three provinces (British Columbia, Ontario, Quebec). Five other centres are planning on implementing a REBOA program in the next 2 years. The number of REBOA cases performed ranged from 0 to 30 (median 2). Factors contributing most to successful program implementation were having physician champions and patient populations with sufficient REBOA candidates, while cost and lack of expertise were the greatest barriers identified. CONCLUSION: As of July 2021, 21.9% (7/32) of Canadian Level 1 and Level 2 trauma centres have a REBOA program. Physician champions and a patient population with sufficient numbers of REBOA candidates were the most important factors contributing to successful implementation of these programs.
Authors: Megan Brenner; Kenji Inaba; Alberto Aiolfi; Joseph DuBose; Timothy Fabian; Tiffany Bee; John B Holcomb; Laura Moore; David Skarupa; Thomas M Scalea Journal: J Am Coll Surg Date: 2018-02-06 Impact factor: 6.113
Authors: Syed Morad Hameed; Nadine Schuurman; Tarek Razek; Darrell Boone; Rardi Van Heest; Tracey Taulu; Nasira Lakha; David C Evans; D Ross Brown; Andrew W Kirkpatrick; Henry T Stelfox; Dianne Dyer; Mary van Wijngaarden-Stephens; Sarvesh Logsetty; Avery B Nathens; Tanya Charyk-Stewart; Sandro Rizoli; Lorraine N Tremblay; Frederick Brenneman; Najma Ahmed; Elsie Galbraith; Neil Parry; Murray J Girotti; Guiseppe Pagliarello; Nancy Tze; Kosar Khwaja; Natalie Yanchar; John M Tallon; J Andrew I Trenholm; Candance Tegart; Ofer Amram; Myriam Berube; Usmaan Hameed; Richard K Simons Journal: J Trauma Date: 2010-12
Authors: Marianne A Thrailkill; Kevin H Gladin; Catherine R Thorpe; Teryn R Roberts; Jae H Choi; Kevin K Chung; Corina N Necsoiu; Todd E Rasmussen; Leopoldo C Cancio; Andriy I Batchinsky Journal: Scand J Trauma Resusc Emerg Med Date: 2021-01-06 Impact factor: 2.953
Authors: Ramiro Manzano Nunez; Maria Paula Naranjo; Esteban Foianini; Paula Ferrada; Erika Rincon; Herney Andrés García-Perdomo; Paola Burbano; Juan Pablo Herrera; Alberto F García; Carlos A Ordoñez Journal: World J Emerg Surg Date: 2017-07-14 Impact factor: 5.469