Abstract
Using the intra-aortic balloon occlusion (IABO) and monitoring the radial and femoral artery pressure, we were able to successfully treat a 32-year-old woman in hemorrhagic shock due to a penetrating abdominal wound, without major adverse effects. The patient was discovered on the floor, having stabbed herself in the abdomen. On arrival to our hospital, her level of consciousness was Japan coma scale III-200. Her systolic blood pressure was 50 mmHg. We inserted the IABO catheter, while giving a large bolus of rapid infusion. With the IABO catheter in place, circulation was temporarily stabilized, and an emergency surgery was performed. Because the inferior vena cava and the portal vein was injured, her blood pressure decreased when the IABO balloon was deflated during surgery. Therefore, we controlled the degree of occlusion by adjusting the volume of the balloon, according to the surgical process and the monitored radial and femoral artery pressure. Although the aortic occlusion lasted for nearly 2 hours, no major adverse effect was noted post-operatively. By monitoring the femoral artery pressure and adjusting the IABO balloon volume, longer aortic interception may be achieved in cases of massive abdominal bleeding.
