• Jostein Rødseth Brede, Arne Kristian Skulberg, Marius Rehn, Kjetil Thorsen, Pål Klepstad, Ida Tylleskär, Bjørn Farbu, Jostein Dale, Trond Nordseth, Rune Wiseth, and Andreas Jørstad Krüger.
• Department of Emergency Medicine and Pre-Hospital Services, St. Olav's Hospital, Trondheim University Hospital, Prinsesse Kristinas Gate 3, 7030, Trondheim, Norway. Jostein.brede@norskluftambulanse.no.
• Trials. 2021 Jul 31; 22 (1): 511.

BackgroundSurvival after out-of-hospital cardiac arrest (OHCA) is poor and dependent on high-quality cardiopulmonary resuscitation. Resuscitative endovascular balloon occlusion of the aorta (REBOA) may be advantageous in non-traumatic OHCA due to the potential benefit of redistributing the cardiac output to organs proximal to the aortic occlusion. This theory is supported by data from both preclinical studies and human case reports.MethodsThis multicentre trial will enrol 200 adult patients, who will be randomised in a 1:1 ratio to either a control group that receives advanced cardiovascular life support (ACLS) or an intervention group that receives ACLS and REBOA. The primary endpoint will be the proportion of patients who achieve return of spontaneous circulation with a duration of at least 20 min. The secondary objectives of this trial are to measure the proportion of patients surviving to 30 days with good neurological status, to describe the haemodynamic physiology of aortic occlusion during ACLS, and to document adverse events.DiscussionResults from this study will assess the efficacy and safety of REBOA as an adjunctive treatment for non-traumatic OHCA. This novel use of REBOA may contribute to improve treatment for this patient cohort.Trial RegistrationThe trial is approved by the Regional Committee for Medical and Health Research Ethics in Norway (reference 152504) and is registered at ClinicalTrials.gov (reference NCT04596514) and as Universal Trial Number WHO: U1111-1253-0322.© 2021. The Author(s).

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