The use of aortic balloon occlusion in traumatic shock: first report from the ABO trauma registry.

PURPOSE: Resuscitative endovascular balloon occlusion of the aorta (REBOA) is a technique for temporary stabilization of patients with non-compressible torso hemorrhage. This technique has been increasingly used worldwide during the past decade. Despite the good outcomes of translational studies, clinical studies are divided. The aim of this multicenter-international study was to capture REBOA-specific data and outcomes. METHODS: REBOA practicing centers were invited to join this online register, which was established in September 2014. REBOA cases were reported, both retrospective and prospective. Demographics, injury patterns, hemodynamic variables, REBOA-specific data, complications and 30-days mortality were reported. RESULTS: Ninety-six cases from 6 different countries were reported between 2011 and 2016. Mean age was 52 ± 22 years and 88% of the cases were blunt trauma with a median injury severity score (ISS) of 41 (IQR 29-50). In the majority of the cases, Zone I REBOA was used. Median systolic blood pressure before balloon inflation was 60 mmHg (IQR 40-80), which increased to 100 mmHg (IQR 80-128) after inflation. Continuous occlusion was applied in 52% of the patients, and 48% received non-continuous occlusion. Occlusion time longer than 60 min was reported as 38 and 14% in the non-continuous and continuous groups, respectively. Complications, such as extremity compartment syndrome (n = 3), were only noted in the continuous occlusion group. The 30-day mortality for non-continuous REBOA was 48%, and 64% for continuous occlusion. CONCLUSIONS: This observational multicenter study presents results regarding continuous and non-continuous REBOA with favorable outcomes. However, further prospective studies are needed to be able to draw conclusions on morbidity and mortality.

Expression of epithelial membrane antigen and secretory component in carcinomas of the laryngeal ventricle, epiglottis and vocal cord.

Expression of epithelial membrane antigen (EMA) and secretory component (SC) in 11 laryngeal carcinomas from the laryngeal ventricle was studied immunohistochemically and the results were compared with findings in carcinomas originating from the epiglottis and vocal cord. EMA was almost constantly present in laryngeal carcinomas of each type, while the expression of SC was observed in 7 of 11 (64%) ventricle carcinomas, 9 of 34 (26%) carcinomas from the epiglottis and 2 of 11 (18%) carcinomas from the vocal cord. In 4 ventricle carcinomas, immunostaining for SC was intense. It would appear that some carcinomas in the laryngeal ventricle originate from cells of the secretory glandular acini or the epithelium.