Feasibility and Clinical Outcomes of Resuscitative Endovascular Balloon Occlusion of the Aorta in Patients with Traumatic Shock: A Single-Center 5-Year Experience

Abstract

Background: Resuscitative endovascular balloon occlusion of the aorta (REBOA) has recently gained popularity as an adjunct to resuscitation of patients with traumatic shock. However, the effectiveness of REBOA is still debated because of inconsistent indications across centers and the lack of medical records. The purpose of this study was to investigate the effectiveness and feasibility of REBOA by analyzing clinical results from a single center. Methods: This study included 96 patients who underwent REBOA between August 2016 and September 2021 at a regional trauma center according to the center's treatment algorithm for traumatic shock. Medical records, including the time of the decision to conduct the REBOA procedure, time of operation, type of aortic occlusion, and clinical outcomes, were collected prospectively and analyzed retrospectively. Patients were classified by RE-BOA protocol (group 1, 2, or 3) and survival status (survivor or non-survivor) for analysis. Results:The overall success rate of the procedure was 97.9%, and the survival rate was 32.6%. In survivors, blood pressure was higher than in non-survivors both before the RE-BOA procedure (p=0.002) and after aortic occlusion (p=0.03). The total aortic occlusion time was significantly shorter (p=0.001) and the proportion of partial aortic occlusion was significantly higher (p=0.014) among the survivors. The non-survivors had more acidosis (p<0.001) and higher lactate concentrations (p<0.001) than the survivors. Conclusion: REBOA may be a feasible bridge therapy for resuscitation of patients with traumatic shock. Prompt and accurate decision-making to perform REBOA followed by damage control surgery could improve survival rates and clinical outcomes.

Nomogram for predicting in-hospital mortality in trauma patients undergoing resuscitative endovascular balloon occlusion of the aorta: a retrospective multicenter study

“…“Complete occlusion” was defined as balloon inflation until the surgeon perceives resistance against the aortic wall during inflation using a syringe. 9 In contrast, “partial occlusion” was defined as gradual inflation until proximal hemodynamics improves without feeling resistance. 10 When the target blood pressure was not maintained by partial occlusion, additional inflation, including total occlusion, was conducted, which was defined as “partial + total occlusion.” When total occlusion was performed followed by deflation (partial occlusion), it was also defined as “partial + total occlusion”.…”

Contemporary Utilization and Outcomes of Resuscitative Endovascular Balloon Occlusion of the Aorta for Traumatic Noncompressible Torso Hemorrhage in Korea: A Retrospective Multi-Center Study

“…Despite the potential benefit of REBOA, comprehensive national studies on REBOA are scarce. Prior reports have been narrow in scope, concentrating on specific injuries such as pelvic fractures, initial experiences, or single-center practices [5][6][7]. Overcoming this shortfall is paramount to development of national policies and guidelines.…”

Commentary: Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA): Live More?

“…This study aimed to investigate the effectiveness and feasi bility of resuscitative endovascular balloon occlusion of the aorta (REBOA) by analyzing the clinical outcomes of REBOA in patients with traumatic shock [1]. Patient data were collected prospectively, and medical records were analyzed retrospectively.…”