REBOA and the Open Abdomen

Abstract

Background: Uncontrolled hemorrhage is a significant cause of death worldwide. Rapid bleeding control is a major life saving goal. Resuscitative endovascular balloon of the aorta (REBOA) is a minimally invasive technique that temporarily occludes the aorta and achieves hemorrhage control.

Methods: We present a case series of patients that underwent emergent laparotomy due hemorrhagic shock and were stabilized intraoperatively using REBOA.

Results: Between December 2018 and September 2021, intraoperative REBOA was inserted in six patients. Etiologies included two postpartum hemorrhages, two gastrointestinal bleeds and two trauma cases. REBOA was positioned and inflated in the descending aorta (n = 3) and infrarenal aorta (n = 3). In all cases, REBOA resulted in immediate stabilization of blood pressure, enabling definitive treatment. Partial inflation was performed in all cases after initial stabilization. There was one minor access related complication, treated successfully. There was no mortality at 6 months follow up.

Conclusions: REBOA is another important resuscitative tool to be considered, also in the open abdomen. It allows
for hemodynamic stabilization and enables definitive surgical repair of other major injuries.