Military Medical Research最新文献

Dear Editor,

Most battlefield casualties occur prior to the arrival of medical facilities. Uncontrollable hemorrhage accounts for more than 90% of those potentially survivable battlefield casualties [1]. In both military and civilian conditions, non-compressible torso hemorrhage always caused rapid exsanguination and high mortality rates before definitive treatment [2]. More than half of the deaths due to non-compressible torso hemorrhage occur before hospital care can be provided [2]. Therefore, early and rapid pre-hospital hemorrhage control is essential to reduce mortality.

Resuscitative endovascular balloon occlusion of the aorta (REBOA) is a life-saving procedure for patients with non-compressible hemorrhage and severe hemorrhagic shock [3]. In addition to in-hospital REBOA, urgent REBOA can be rapidly completed in grim pre-hospital situations for patients [4]. Thus, pre-hospital REBOA application for the treatment of life-threatening hemorrhages has attracted increasing attention. In patients who receive timely pre-hospital REBOA treatment, the mortality can be reduced to less than 40% [5]. In this letter, we focus on the pre-hospital application of REBOA for managing life-threatening traumatic hemorrhages in both military and civilian settings.

REBOA was first introduced by the US Army in the Korean War to treat intraabdominal hemorrhages. With significant improvements in endovascular equipment and techniques, pre-hospital REBOA has attracted renewed clinical interest. Recently, the US Army reported the use of pre-hospital REBOA in treating modern combat casualties [6]. After pre-hospital REBOA treatment, the patients were finally hemodynamically stabilized and safely evacuated without any apparent complications. Furthermore, the Russian Army have also validated the effectiveness of pre-hospital REBOA on the battlefield [7]. When combined with other resuscitation strategies like blood transfusion, pre-hospital REBOA can further enhance survival rates. Therefore, it is evident that pre-hospital REBOA is an effective method for acute care of massive hemorrhage and can be safely performed in the battlefield setting as an emergency treatment option for individuals at risk of cardiovascular failure due to injuries sustained in combat situations. On the battlefield, frontline implementation of REBOA allows temporary hemorrhage control and facilitates timely evacuation to the hospital, thereby reducing mortality rate and improving overall treatment outcomes, simultaneously saving lives among military personnel. This technology is of great significance for military applications and may become an essential skill for military training programs and medical practices in the future.

In addition to the battlefield environment, pre-hospital REBOA is also suitable for trauma patients in civilian conditions. Uncontrolled hemorrhagic shock or cardiac arrest accounts for a significant percentage of trauma patients. Some of these pa

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