Aortic Occlusion for Resuscitation in Trauma and Acute Care Surgery

Study Overview
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Brief Summary
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Aortic occlusion (AO) for trauma has traditionally been accomplished by supra-diaphragmatic clamping of the descending thoracic aorta via emergent thoracotomy or as an initial step during laparotomy.

Detailed Description
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An evolution in endovascular technologies, however, has provided additional means by which to achieve AO. Expanding experience with the utilization of balloon occlusion in the setting of abdominal aortic rupture due to chronic vascular disease has demonstrated the potential of these new technologies. Discussion of the employment of endovascular AO in the realm of trauma has led to the description of this approach and the demonstration of its effectiveness in animal models of severe hemorrhage. The purpose of the present study is to prospectively examine the modern utilization of AO in the acute resuscitation of trauma and acute care surgery patients in shock.

Official Title
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Aortic Occlusion for Resuscitation in Trauma and Acute Care Surgery (AORTA)

Conditions
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Aortic Occlusion

Intervention / Treatment
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* Procedure: utilization of AO in the acute resuscitation of trauma and acute care surgery patients in shock.


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: All adult (age ≥ 18 years) trauma and acute care surgery patients treated with resuscitative AO (via open or endovascular means) in the acute phases after injury Transient or refractory hypotension (systolic blood pressure <90mmHg) with a positive abdominal focused abdominal sonography in trauma (FAST) scan, severe pelvic fracture(s), or neither with persistent hypotension without obvious source Chest x-ray without evidence of thoracic aortic injury Subject treatment includes internal aortic cross-clamp or would have likely benefited from an internal aortic cross-clamp Exclusion Criteria: Subject < 18 years of age Prisoner Evidence of cardiac, thoracic aortic, or great vessel injury identified in primary survey, FAST scan, and/or x-rays Any open/exsanguinating upper extremity wound

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 100 Years

Sexes Eligible for Study
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All

Study Plan
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How is the study designed?
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Arms and Interventions

| Intervention/Treatment |
| --- |
|Procedure: utilization of AO in the acute resuscitation of trauma and acute care surgery patients in shock.|AO to facilitate the acute resuscitation of trauma and acute care surgery patients in shock.|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Demographics | Age in years | 01 July 2015 through 31st December 2024 | 
| Demographics- Gender | Male or Female | 01 July 2015 through 31st December 2024 | 
| Demographics-Height | Height measured in Inches | 01 July 2015 through 31st December 2024 | 
| Demographics- Weight | Weight measured in pounds | 01 July 2015 through 31st December 2024 | 
| Injury Data | Mechanism classification - Penetrating, Blunt or Non-trauma Hemmorhage | 01 July 2015 through 31st December 2024 | 
| Injury Mechanism Type | Gunshot wound, Motor vehicle accident, stab wound, fall | 01 July 2015 through 31st December 2024 | 
| Body Region | Head/Neck, Chest, Abdomen, pelvis or Extremities | 01 July 2015 through 31st December 2024 |