title: Resuscitative endovascular balloon occlusion of the aorta in trauma patients in youth.
abstract: Resuscitative endovascular balloon occlusion of the aorta (REBOA) has received increasing attention for critically uncontrolled hemorrhagic shock. However, the efficacy of REBOA in patients in youth is unknown.
  
  
  
  The aim of this study was to evaluate the mortality and characteristics of patients of age ≤18 years with severe traumatic injury who received REBOA.
  
  
  
  We retrospectively analyzed observational cohort data from the Japan Trauma Data Bank (JTDB) from 2004 to 2015. All patients ≤18 years old who underwent REBOA were included. Clinical characteristics and mortalities were analyzed and compared among patients ≤15 years old (young children) and 16-18 years old (adolescents).
  
  
  
  Of the 236,698 patients in the JTDB (2004-2015), 22,907 patients were 18 years old or younger. A total of 3,440 patients without survival data were excluded. Of the remaining 19,467, 54 (0.3%) patients underwent REBOA, among which 15 (27.8%) were young children. Both young children and adolescents who underwent REBOA were seriously injured (median Injury Severity Score [ISS], 41 and 38, respectively). Also, 53.3% of young children and 38.5% of adolescents survived to discharge after undergoing REBOA.
  
  
  
  In a cohort of young trauma patients from the JTDB who underwent REBOA to control hemorrhage, we found that both young children and adolescents who underwent REBOA were seriously injured and had an equivalent survival rate compared to the reported survival rate from studies in adults. REBOA treatment may be a reasonable option in severely injured young patients in the appropriate clinical settings. Further prospective studies are needed to confirm our findings.
  
  
  
  Epidemiologic study, level III; therapeutic study, level IV.
authors.affiliation: From the Department of Emergency Medicine (T.N., C.C.), University of New Mexico, Albuquerque, New Mexico; Children's Hospital Los Angeles (S.M.), Los Angeles, California; Kenwakai Otemachi Hospital (Y.T.), Kitakyushu, Japan; and Department of Surgery (S.G., S.W.L.), University of New Mexico, Albuquerque, New Mexico.
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Norii
authors.forename: Shin
authors.initials: S
authors.lastname: Miyata
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Terasaka
authors.forename: Sundeep
authors.initials: S
authors.lastname: Guliani
authors.forename: Stephen W
authors.initials: SW
authors.lastname: Lu
authors.forename: Cameron
authors.initials: C
authors.lastname: Crandall
mesh_terms: D000293:Adolescent; D000367:Age Factors; D001011:Aorta; D021721:Balloon Occlusion / Q000401:mortality / Q000706:statistics & numerical data*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D012151:Resuscitation / Q000379:methods / Q000401:mortality / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D012771:Shock, Hemorrhagic / Q000401:mortality / Q000628:therapy*; D014947:Wounds and Injuries / Q000150:complications / Q000401:mortality / Q000628:therapy