REBOA was developed to address the challenge of managing non-compressible torso haemorrhage, a major cause of potentially preventable death after traumatic injury. It involves placement of an endovascular balloon in the aorta to control haemorrhage and to augment afterload in traumatic arrest and haemorrhagic shock states. REBOA is not without significant risk. Occlusion of the aorta results in tissue ischemia followed by reperfusion injury, predisposing to organ dysfunction and cardiovascular collapse. A 2015 study1 found an association between use of REBOA and excess mortality in patients with haemodynamically unstable torso trauma.
There is no high-grade evidence demonstrating that REBOA improves outcomes or survival compared with standard treatment of severe traumatic hemorrhage.2 REBOA does not confer any long-term survival advantage when used in traumatic cardiac arrest compared with standard of care.3
Though it remains unclear if there is are any valid indications for its use, some suggest REBOA may be better suited to prehospital/ remote settings lacking immediate access to definitive surgical therapy.
Important Aspects of History
Published: February 2018
Author: Emma Batistich
Updated: Scott Cameron (April 2021)
Approved by: Northern Region Trauma Network, ADHB, WDHB, CMDHB, NDHB, NRHL, St. John
Review due: 2 years