Use of Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) in Trauma Patients in French Level-1 Trauma Centers: A National Survey

Abstract

Background: The goal of the present national survey was to describe the practices and use of resuscitative endovascular balloon occlusion of the aorta (REBOA) in France in level-1 trauma centers.

Methods: Between January and December 2023, the ACUTE SFAR (Société Française d’Anesthésie et de Réanimation) committee sent a numeric survey to each French level-1 trauma center. This survey was focused on REBOA in trauma management including: use, protocol (indications, placement, aortic occlusion durations), aortic occlusion location (Zone 1/Zone 3), partial occlusion (pREBOA), device characteristics, operator, specific complications.

Results: Among the 41 French level-1 trauma centers, 18 (44%) had incorporated REBOA in their algorithm. In 2022, 78% (14/18) of these centers had experienced between 1 and 5 REBOA placements, 11% (2/18) between 6 and 10, and 6% (1/18) 10 or more placements. The frequency of REBOA procedures increased with the duration of REBOA availability at the center. A protocol for REBOA placement was present in 28% (5/18) of centers. An anesthesiologistintensivist was the operator in 50% (9/18), a surgeon in 28% (5/18), and a radiologist in 22% (4/18) of centers. The proportion of centers using REBOA in Zone 1 was 39% (7/18), and pREBOA 33% (6/18). The maximum duration of complete aortic occlusion was specified in 50% of centers for Zone 1 and 78% for Zone 3.

Conclusions: Use of REBOA is modestly spread among the French trauma centers, and in less than half of centers. Specific protocols are present. Anesthesiologist-intensivists are the operators in only half of these centers.