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Resuscitative endovascular balloon occlusion of the aorta (REBOA) is commonly used as an adjunct to resuscitation and bridge to definitive control of non-compressible torso hemorrhage in patients with hemorrhagic shock. It has also been performed for patients with neurogenic shock to support the central aortic pressure necessary for cerebral, coronary and spinal cord perfusion. Although volume replacement and vasopressors are the cornerstones of the management of neurogenic shock, we believe that a REBOA can be used as an adjunct in carefully selected cases to prevent prolonged hypotension and the risk of further anoxic spinal cord injury. This manuscript aims to propose a new damage control algorithmic approach to refractory neurogenic shock that includes the use of a REBOA in Zone 3. There are still unanswered questions on spinal cord perfusion and functional outcomes using a REBOA in Zone 3 in trauma patients with refractory neurogenic shock. However, we believe that its use in these case scenarios can be beneficial to the overall outcome of these patients.

Oscar Javier Castro, Department of Neurosurgery, Fundacion Valle del Lili, Cali, Colombia

orcid_id14.png https://orcid.org/0000-0002-3170-2377

Juan Alfonso Uribe, Department of Neurosurgery, Fundacion Valle del Lili, Cali, Colombia

orcid_id14.png https://orcid.org/0000-0002-8747-8431

Parra, M. W., Ordoñez, C. A., Mejia, D., Caicedo, Y., Lobato, J. M., Castro, O. J., Uribe, J. A., & Velasquez, F. (2024). Damage control approach to refractory neurogenic shock: a new proposal to a well-established algorithm. Colombia Medica, 52(2), e4164800. https://doi.org/10.25100/cm.v52i2.4800 (Original work published September 29, 2021)

Ruiz IA, Squair JW, Phillips AA, Lukac CD, Huang D, Oxciano P, et al. Incidence and Natural Progression of Neurogenic Shock after Traumatic Spinal Cord Injury. J Neurotrauma 2018;35:461–6. https://doi.org/10.1089/neu.2016.4947.

Fox AD. Spinal shock. Assessment & treatment of spinal cord injuries & neurogenic shock. JEMS 2014;39:64–7.

Kaptanoglu L, Kurt N, Sikar HE. Current approach to liver traumas. Int J Surg 2017;39:255–9. https://doi.org/10.1016/j.ijsu.2017.02.015.

Ordoñez CA, Parra M, Caicedo Y, Padilla N, Rodriguez F, Serna JJ, et al. REBOA as a New Damage Control Component in Hemodynamically Unstable NTCH patients. Colomb Med 2020.

Ordoñez CA, Parra MW, Serna JJ, Rodríguez H F, García AF, Salcedo A, et al. Damage Control Resuscitation : REBOA as the New Fourth pillar. Colomb Med 2020. https://doi.org/10.25100/cm.v51i4.4353.

Kim DH, Chang YR, Yun J-H. Effects of Resuscitative Endovascular Balloon Occlusion of the Aorta in Neurotrauma: Three Cases. J Trauma Inj 2020;33:175–80. https://doi.org/10.20408/jti.2020.0047.

Gray S, Dieudonne B. Resuscitative Endovascular Balloon Occlusion of the Aorta as an Adjunct in a Patient with Neurogenic Shock. Cureus 2018;10. https://doi.org/10.7759/cureus.3375.

Advanced trauma life support (ATLS): 10th Edition. 2018. https://doi.org/10.1111/j.1365-2044.1993.tb07026.x.

Kowalski A, Brandis D. Shock Resuscitation. 2020.

Eckert MJ, Martin MJ. Trauma: Spinal Cord Injury. Surg Clin North Am 2017;97:1031–45. https://doi.org/10.1016/j.suc.2017.06.008.

Benham DA, Calvo RY, Carr MJ, Wessels LE, Schrader AJ, Lee JJ, et al. Is cerebral perfusion maintained during full and partial reboa in hemorrhagic shock conditions? J Trauma Acute Care Surg 2021. https://doi.org/10.1097/TA.0000000000003124.

Long KN, Houston R, Watson JDB, Morrison JJ, Rasmussen TE, Propper BW, et al. Functional outcome after resuscitative endovascular balloon occlusion of the aorta of the proximal and distal thoracic aorta in a swine model of controlled hemorrhage. Ann. Vasc. Surg., vol. 29, Elsevier Inc.; 2015, p. 114–21. https://doi.org/10.1016/j.avsg.2014.10.004.

Leather RP, Williams GM, Perler BA, Burdick JF, Osterman FA, Mitchell SA, et al. Angiographic localization of spinal cord blood supply and its relationship to postoperative paraplegia. J Vasc Surg 1991;13:23–35. https://doi.org/10.1067/mva.1991.25611.

Eliason J, Myers D, Ghosh A, Morrison J, Mathues A, Durham L, et al. Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA): Zone I Balloon Occlusion Time Affects Spinal Cord Injury in the Nonhuman Primate Model. Ann Surg 2019:1. https://doi.org/10.1097/SLA.0000000000003408.

Wadouh F, Lindemann EM, Arndt CF, Hetzer R, Borst HG. The arteria radicularis magna anterior as a decisive factor influencing spinal cord damage during aortic occlusion. J Thorac Cardiovasc Surg 1984;88:1–10.

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Received 2021-03-30
Accepted 2021-08-26
Published 2024-04-26