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Curr Opin Crit Care · Dec 2016
ReviewResuscitative endovascular balloon occlusion of the aorta: promise, practice, and progress?
- Zane B Perkins, Robbie A Lendrum, and Karim Brohi.
- aCentre for Trauma Sciences, Blizard Institute, Queen Mary University of London, London bNHS Lothian, Royal Infirmary of Edinburgh, Edinburgh, UK.
- Curr Opin Crit Care. 2016 Dec 1; 22 (6): 563-571.
Purpose Of ReviewResuscitative endovascular balloon occlusion of the aorta (REBOA) is a minimally invasive damage control procedure for life-threatening abdominal or pelvic haemorrhage. The purpose of this review is to summarize the current understanding and experience with REBOA, outline potential future applications of this technology, and highlight priority areas for further research.Recent FindingsREBOA is a feasible method of achieving temporary aortic occlusion and can be performed rapidly, with a high degree of success, in the emergency setting (including at the scene of injury) by appropriately trained clinicians. The procedure supports central perfusion, controls noncompressible haemorrhage, and may improve survival in certain profoundly shocked patient groups; but is also associated with significant risks, including ischaemic tissue damage and procedural complications. Evolutions of this strategy are being explored, with promising proof-of-concept studies in the fields of partial aortic occlusion and the combination of REBOA with extracorporeal support.SummaryNoncompressible torso haemorrhage is the leading cause of preventable trauma deaths. The majority of these deaths occur soon after injury, often before any opportunity for definitive haemorrhage control. For a meaningful reduction in trauma mortality, novel methods of rapid haemorrhage control are required.
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