Resuscitative Endovascular Balloon Occlusion of the Aorta: What You Need to Know

Hemorrhage remains one of the leading causes of death from traumatic injury in both the civilian and military populations. Resuscitative endovascular balloon occlusion of the aorta (REBOA) is a minimally invasive technique that can be used to treat hemorrhage in the critically ill. An alternative to maximally invasive methods such as resuscitative thoracotomy, REBOA is a temporizing measure to prevent exsanguination and allow for transition to definitive hemorrhage control. It is easily deployed by trained users and does not require surgical expertise to place. Its use has increased over the past decade with a growing body of literature that suggests it improves outcomes in select hemorrhagic trauma patients compared with patients who do not receive REBOA. REBOA has also been used for select nontraumatic cases. Judicious patient selection, knowing the technical aspects of placing REBOA, and clarity regarding its indications are key to maximize its efficacy as a mitigatory tool in hemorrhagic shock. This "What You Need To Know" review presents current evidence regarding use of REBOA for the acute care surgeon.