Novel Methods for Hemorrhage Control: Resuscitative Endovascular Balloon Occlusion of the Aorta and Emergency Preservation and Resuscitation

Abstract

Hemorrhage is the leading cause of preventable death after trauma. Junctional and extremity hemorrhage can be temporized with direct pressure and tourniquet application, but noncompressible torso hemorrhage has traditionally required operative or angiographic intervention. Retrograde endovascular balloon occlusion of the aorta (REBOA) can temporize patients with hemorrhage below the diaphragm long enough to enable definitive surgery. REBOA is increasingly available in US trauma centers but prospective, randomized demonstration of efficacy is not yet available. Emergency perfusion and resuscitation is an investigational therapy, limited to use in patients with cardiac arrest due to hemorrhage.

Keywords: Emergency department thoracotomy; Emergency perfusion and resuscitation; Noncompressible torso hemorrhage; Resuscitative endovascular occlusion of the aorta.