The role of REBOA in patients in traumatic cardiac arrest subsequent to hemorrhagic shock: a scoping review

S A S Slot; S E van Oostendorp; L J Schoonmade; L M G Geeraedts

doi:10.1007/s00068-022-02154-z

The role of REBOA in patients in traumatic cardiac arrest subsequent to hemorrhagic shock: a scoping review

Eur J Trauma Emerg Surg. 2023 Apr;49(2):693-707. doi: 10.1007/s00068-022-02154-z. Epub 2022 Nov 6.

Authors

S A S Slot¹, S E van Oostendorp^{2

3}, L J Schoonmade⁴, L M G Geeraedts²

Affiliations

¹ Amsterdam UMC, Location VUMC, Department of Surgery, Section Trauma Surgery, Vrije Universiteit Amsterdam, De Boelelaan 1117, P.O. Box 7057, 1007 MB, Amsterdam, The Netherlands. sasslot@outlook.com.
² Amsterdam UMC, Location VUMC, Department of Surgery, Section Trauma Surgery, Vrije Universiteit Amsterdam, De Boelelaan 1117, P.O. Box 7057, 1007 MB, Amsterdam, The Netherlands.
³ Department of Surgery, Rode Kruis Ziekenhuis, Beverwijk, The Netherlands.
⁴ Medical Library, Vrije Universiteit Amsterdam, De Boelelaan 1117, P.O. Box 7057, 1007 MB, Amsterdam, The Netherlands.

Abstract

Purpose: Resuscitative endovascular balloon occlusion of the aorta (REBOA) is a useful adjunct in treatment of patients in severe hemorrhagic shock. Hypothetically, REBOA could benefit patients in traumatic cardiac arrest (TCA) as balloon occlusion of the aorta increases afterload and may improve myocardial performance leading to return of spontaneous circulation (ROSC). This scoping review was conducted to examine the effect of REBOA on patients in TCA.

Methods: This scoping review was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Extension for Scoping Reviews (PRISMA-ScR) Statement. PubMed, EMBASE.com and the Web of Science Core Collection were searched. Articles were included if they reported any data on patients that underwent REBOA and were in TCA. Of the included articles, data regarding SBP, ROSC and survival were extracted and summarized.

Results: Of 854 identified studies, 26 articles met criteria for inclusion. These identified a total of 785 patients in TCA that received REBOA (presumably less because of potential overlap in patients). This review shows REBOA elevates mean SBP in patients in TCA. The achievement of ROSC after REBOA deployment ranged from 18.2% to 67.7%. Survival to discharge ranged from 3.5% to 12.1%.

Conclusion: Overall, weak evidence is available on the use of REBOA in patients in TCA. This review, limited by selection bias, indicates that REBOA elevates SBP and may benefit ROSC and potentially survival to discharge in patients in TCA. Extensive further research is necessary to further clarify the role of REBOA during TCA.

Keywords: Hemorrhagic shock; REBOA; Resuscitative endovascular balloon occlusion of the aorta; Traumatic cardiac arrest.

Publication types

Review

MeSH terms

Aorta
Balloon Occlusion* / adverse effects
Endovascular Procedures* / adverse effects
Heart Arrest* / complications
Humans
Resuscitation / adverse effects
Shock, Hemorrhagic*