Hybrid Trauma Management: Is It the Way We Are Heading?
Keywords:Hybrid trauma management, EVTM, Hybrid OR, Hybrid ER, Hybrid surgery, Endovascular repair
Background: Hybrid trauma management, namely, the combination of open and endovascular techniques and/or the application of endovascular methods in the OR/ER is a quickly growing concept worldwide. However, its implications are not well established. We aimed to review the current data regarding hybrid trauma management in medical literature.
Methods: A review of the medical literature published between 2000 and 2020 using PubMed and OVID Medline databases was performed in search for clinical studies regarding hybrid trauma treatments. Case reports were excluded from this review. The manuscripts were analyzed regarding the mechanism, location and type of injury, endovascular and surgical techniques utilized and outcomes.
Results: Fourteen studies reporting hybrid trauma management of a total of 1049 patients met the inclusion criteria and were analyzed. Blunt trauma was the leading trauma mechanism (87.13%) and the most common procedure was transcatheter arterial embolization (TAE), performed in 29.74% of patients. The overall mortality was 15.16%. Regarding case control studies, 85.71% have shown hybrid trauma management to be associated with a shorter time from arrival to intervention, 42.86% reported lower rates of unfavorable outcome 28.57% reported reduced requirement for red blood cell transfusion as compared with conventional management.
Conclusions: This review did not find strong evidence supporting hybrid trauma management as a standard care. However, accumulating data suggests that hybrid management may be associated with a shorter time from arrival to intervention, lower rates of unfavorable outcome and reduced requirement for red blood cell transfusion as compared with conventional management of trauma patients.