TEE guided REBOA deflation following ROSC for non-traumatic cardiac arrest

Area of Science:

• Emergency Medicine
• Cardiology
• Critical Care

Background:

• Resuscitative endovascular balloon occlusion of the aorta (REBOA) is primarily used for non-compressible torso hemorrhage.
• Emerging evidence suggests REBOA's potential in managing non-traumatic refractory cardiac arrest.
• Aortic occlusion during CPR may enhance cardio-cerebral perfusion and facilitate return of spontaneous circulation (ROSC).

Observation:

• A case of non-traumatic out-of-hospital cardiac arrest is presented.
• REBOA was successfully implemented in the emergency department, leading to ROSC.
• Transesophageal echocardiography (TEE) was utilized to guide post-ROSC management and balloon deflation.

Findings:

• REBOA application in non-traumatic cardiac arrest can achieve ROSC.
• TEE provides valuable real-time guidance for managing REBOA after ROSC.
• This case demonstrates a potential strategy for utilizing REBOA in refractory cardiac arrest.

Implications:

• Further research is needed to establish optimal patient selection and post-ROSC management protocols for REBOA in cardiac arrest.
• TEE may play a crucial role in optimizing REBOA therapy and patient outcomes.
• This case contributes to the growing body of evidence supporting REBOA as a bridge therapy in critical cardiac events.