Is there a role for REBOA? A system assessment

Area of Science:

• Trauma Surgery
• Emergency Medicine
• Vascular Surgery

Background:

• Hemorrhagic shock poses a significant challenge in trauma care.
• Resuscitative endovascular balloon occlusion of the aorta (REBOA) is an emerging intervention for managing life-threatening hemorrhage.
• Quantifying the need for REBOA is crucial for its effective implementation.

Purpose of the Study:

• To analyze institutional experience with trauma patients in hemorrhagic shock.
• To quantify the potential need for resuscitative endovascular balloon occlusion of the aorta (REBOA).
• To identify patient characteristics and injury patterns relevant to REBOA candidacy.

Main Methods:

• Retrospective review of trauma activations over a three-year period.
• Patients presenting with hemorrhagic shock were categorized into REBOA Candidate and Non-candidate groups.
• Comparison of injuries, physiological parameters, outcomes, and interventions between groups.

Main Results:

• Only 37 (0.44%) of 7643 trauma activations met inclusion criteria; 16 were potential REBOA candidates.
• REBOA candidates and non-candidates did not differ in injury severity, physiology, age, or transfusion requirements.
• Of the 16 candidates, 8 (50%) had injuries potentially benefiting from REBOA, while 7 (44%) had injuries that could be harmed by it.

Conclusions:

• The number of trauma patients who would potentially benefit from REBOA is small in this cohort.
• Findings do not support system-wide adoption of REBOA in the studied region based on current criteria.
• Further research is needed to refine REBOA selection criteria and assess its broader utility.