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Background <p>Noncompressible torso hemorrhage (NCTH) poses a&#xa0;considerable problem in prehospital care as bleeding control is not possible in this situation. Resuscitative endovascular balloon occlusion of the aorta (REBOA) is a&#xa0;minimally invasive endovascular procedure that could be an option for temporary bleeding control or reduction. The aim of this study was to review and classify the available literature on the prehospital use of REBOA in the context of traumatic hemorrhagic shock.</p> Methods <p>A literature search was carried out in various databases (PubMed, Embase, Web of Sciences, Google Scholar) using the search terms “prehospital and REBOA” or “prehospital and resuscitative endovascular balloon occlusion of the aorta” to identify relevant studies. Only studies, case series or case reports of prehospital REBOA use were included in the review.</p> Results <p>A total of 15 studies (7&#xa0;case reports, 8&#xa0;case series) with a&#xa0;total of 80&#xa0;patients (45&#xa0;male, 15&#xa0;female, 20&#xa0;without gender information) with a&#xa0;mean age of 41.4 years (range 16–75 years) who underwent prehospital REBOA for hemorrhage control were included in the review and analyzed. Of these, 34&#xa0;patients were treated in a&#xa0;military context and 46&#xa0;patients in a&#xa0;civilian context. The average Injury Severity Score (ISS) was 41.4 (min.&#xa0;9/max.&#xa0;75) points. The use of REBOA was feasible in the prehospital setting with an overall success rate of &gt; 85% ranging from 72% to 100%. The prehospital application leads to a&#xa0;hemodynamic stabilization with a&#xa0;mean systolic blood pressure increase of 50 mm Hg. Of the treated patients 89% could be transported alive to hospital and 45% survived to hospital discharge. Complications were reported in 29%, not all of which were specific to REBOA. Publication bias must be considered and therefore the results have to be interpreted with caution.</p> Conclusion <p>The application of REBOA in the prehospital setting in the context of traumatic hemorrhagic shock is feasible with a&#xa0;high success rate. The majority of patients can be hospitalized but only slightly less than 50% survive to hospital discharge. The currently available evidence relates exclusively to case reports and case series and is therefore still weak. A&#xa0;not insignificant publication bias must be considered.</p>

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„Resuscitative Endovascular Balloon Occlusion of the Aorta“ – REBOA zur Blutungskontrolle im prähospitalen Kontext

  • 期刊论文

  • 发表日期：

    2025年10月29日

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  • Peter Hilbert-Carius,
  • H. Wrigge,
  • F. Streibert,
  • M. Lautenschläger,
  • A. Großstück

摘要

Background

Noncompressible torso hemorrhage (NCTH) poses a considerable problem in prehospital care as bleeding control is not possible in this situation. Resuscitative endovascular balloon occlusion of the aorta (REBOA) is a minimally invasive endovascular procedure that could be an option for temporary bleeding control or reduction. The aim of this study was to review and classify the available literature on the prehospital use of REBOA in the context of traumatic hemorrhagic shock.

Methods

A literature search was carried out in various databases (PubMed, Embase, Web of Sciences, Google Scholar) using the search terms “prehospital and REBOA” or “prehospital and resuscitative endovascular balloon occlusion of the aorta” to identify relevant studies. Only studies, case series or case reports of prehospital REBOA use were included in the review.

Results

A total of 15 studies (7 case reports, 8 case series) with a total of 80 patients (45 male, 15 female, 20 without gender information) with a mean age of 41.4 years (range 16–75 years) who underwent prehospital REBOA for hemorrhage control were included in the review and analyzed. Of these, 34 patients were treated in a military context and 46 patients in a civilian context. The average Injury Severity Score (ISS) was 41.4 (min. 9/max. 75) points. The use of REBOA was feasible in the prehospital setting with an overall success rate of > 85% ranging from 72% to 100%. The prehospital application leads to a hemodynamic stabilization with a mean systolic blood pressure increase of 50 mm Hg. Of the treated patients 89% could be transported alive to hospital and 45% survived to hospital discharge. Complications were reported in 29%, not all of which were specific to REBOA. Publication bias must be considered and therefore the results have to be interpreted with caution.

Conclusion

The application of REBOA in the prehospital setting in the context of traumatic hemorrhagic shock is feasible with a high success rate. The majority of patients can be hospitalized but only slightly less than 50% survive to hospital discharge. The currently available evidence relates exclusively to case reports and case series and is therefore still weak. A not insignificant publication bias must be considered.