Resuscitative Endovascular Balloon Occlusion of the Aorta: Indications, Outcomes, and Training

Crit Care Clin. 2017 Jan;33(1):55-70. doi: 10.1016/j.ccc.2016.08.011.

Abstract

Exsanguinating torso hemorrhage is a leading killer of trauma patients. The most appropriate means of hemorrhage control must be used. Trauma surgeons should have expertise with all approaches for prompt hemorrhage control [laparotomy, thoracotomy, resuscitative endovascular balloon occlusion of the aorta (REBOA), and resuscitative thoracotomy]. REBOA is an exciting adjunct for hemorrhage control as it can be deployed quickly and placed percutaneously. Balloon inflation can vary dependent on patient physiology. REBOA is effective in hemorrhagic shock as a bridge to definitive hemostasis. Endovascular training is important for trauma surgeons caring for patients at high risk of death from traumatic hemorrhage.

Keywords: Aortic balloon; Aortic occlusion; Hemorrhagic shock; Noncompressible torso hemorrhage; Resuscitative endovascular balloon occlusion of aorta; Resuscitative thoracotomy.

Publication types

  • Review

MeSH terms

  • Aorta / injuries*
  • Balloon Occlusion / standards*
  • Endovascular Procedures / standards*
  • Hemorrhage / therapy*
  • Humans
  • Practice Guidelines as Topic*