Just over a year ago London HEMS performed the first pre-hospital regtrograde endovascular balloon occlusion of the aorta (REBOA). This is a potentially lifesaving treatment pioneered by the US military1 for patients with exsanguinating pelvic and lower limb haemorrhage. There are REBOA trials underway in major trauma centres in Australia currently, so it won’t be happening anytime soon in your local Aussie ED, but for an amazing closeup view of roadside REBOA, check out this episode of “An hour to save your life”.
Want to read the literature on REBOA? Here’s some references.
1. Stannard A, Eliason JL, Rasmussen TE. Resuscitative endovascular balloon occlusion of the aorta (REBOA) as an adjunct for hemorrhagic shock. J Trauma. 2011 Dec;71(6):1869-72 (full article free text)
2. Martinelli et al. Intra-Aortic Balloon Occlusion to Salvage Patients with Life-Threatening Hemorrhagic Shocks from Pelvic Fractures J Trauma 2010; 68(4): 942–8 (full article free text)
3. Norii, Crandall, Terasaka. Survival of severe blunt trauma patients treated with resuscitative endovascular balloon occlusion of the aorta compared with propensity score-adjusted untreated patients. J Trauma Acute Care Surg 2015 Apr;78(4):721-8
4. Brenner et al. A Clinical Series of Resuscitative Endovascular Balloon Occlusion of the Aorta for Hemorrhage Control and Resuscitation. J Trauma Acute Care Surg 2013; 75(3): 506–11
5. Morrison et al. Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA): A Bridge to Definitive Haemorrhage Control for Trauma Patients in Scotland? The Surgeon 2014 Jun;12(3):119-20
6. White et al. Endovascular Balloon Occlusion of the Aorta Is Superior to Resuscitative Thoracotomy with Aortic Clamping in a Porcine Model of Hemorrhagic Shock. Surgery 2011; 150(3): 400–9 (full article free text)
7. Avaro et al. Forty-Minute Endovascular Aortic Occlusion Increases Survival in an Experimental Model of Uncontrolled Hemorrhagic Shock Caused by Abdominal Trauma. J Trauma 2011; 71(3): 720–725
8. Morrison et al Aortic Balloon Occlusion Is Effective in Controlling Pelvic Hemorrhage J Surg Res 2012; 177(2): 341–7
9. Markov et al.Physiologic Tolerance of Descending Thoracic Aortic Balloon Occlusion in a Swine Model of Hemorrhagic Shock Surgery 2013; 153(6): 848–56
10. Scott et al. A Novel Fluoroscopy-Free, Resuscitative Endovascular Aortic Balloon Occlusion System in a Model of Hemorrhagic Shock. J Trauma Acute Care Surg 2013; 75(1): 122–8
11. Morrison et al. Use of Resuscitative Endovascular Balloon Occlusion of the Aorta in a Highly Lethal Model of Noncompressible Torso Hemorrhage. Shock 2014; 41(2): 130–7
12. Morrison et al.The Inflammatory Sequelae of Aortic Balloon Occlusion in Hemorrhagic Shock. J. Surg. Res. 2014; pii: S0022-4804(14)00366-7
13. Hörer et al. Intraperitoneal Metabolic Consequences of Supraceliac Aortic Balloon Occlusion in an Experimental Animal Study Using Microdialysis. Ann Vasc Surg 2014; 28(5): 1286–95Posted in Pelvic Trauma, Uncategorized, Vascular accessLeave a Comment on London HEMS pre-hospital REBOA video