REBOA: método adyuvante o puente en el control de la hemorragia

Abstract

Background: Resuscitative endovascular balloon occlusion of the aorta (REBOA) is an endovascular procedure that consists of inflating a compliant balloon in the aorta through a femoral arterial access, with the intention of improving vital organs perfusion. Theoretical basis is similar to resuscitative thoracotomy (RT), with aortic clamping and/or open heart massage, but less invasive and with a lower morbidity. The aorta is divided into 3 zones considering the diaphragm and renal arteries, when using REBOA it is always preferred to inflate the balloon in Zone 1 regardless of the origin of the bleeding and it is only used in Zone 3 in exceptional cases. REBOA is used in various cases of hemorrhagic shock, either secondary to traumatismo or not, it is also used in cardiac arrest cases with good results, as shown in multiple studies in selected patients, nevertheless, using these studies the limitations or the scope of the procedure can not be clarified. Conclusions: The implementation REBOA should be determined based on training, experience, local resources and evacuation times.