Effects of Resuscitative Endovascular Balloon Occlusion of the Aorta in Neurotrauma: Three Cases

Abstract

Resuscitative endovascular balloon occlusion of the aorta (REBOA) is widely performed as an adjunct to resuscitation or bridge to definitive control of non-compressible torso hemorrhage in patients with hemorrhagic shock. It is a crucial adjunct for the maintenance of cerebral and coronary perfusion during resuscitation. However, in polytrauma patients with concomitant neurotrauma, such as traumatic brain injury (TBI) or spinal cord injury, the physiological effects of REBOA are unclear. In this report on REBOA performed in a clinical setting for polytrauma patients with spinal cord injury or TBI, the physiological effects of REBOA in neurotrauma are reviewed.

REBOA as a bridge to brain CT in a patient with concomitant brain herniation and haemorrhagic shock - A case report

“…In our opinion REBOA placement is a safe procedure in a shocked patient where the treatment goals are to obtain a SBP improvement and a bleeding reduction, thus preserving cerebral perfusion pressure and reducing the impact of secondary brain damage [13] .…”

Damage control approach to refractory neurogenic shock: a new proposal to a well-established algorithm

“…Resuscitative endovascular balloon occlusion of the aorta (REBOA) is commonly used as an adjunct to resuscitation and bridge to definitive control of non-compressible torso hemorrhage in patients with hemorrhagic shock 4 , 5 . It has also been performed for patients with neurogenic shock to support the central aortic pressure necessary for cerebral, coronary, and spinal cord perfusion 6 . Gray et al reported a case of successful REBOA in a patient with neurogenic shock secondary to a comminuted fracture at C5 with cord contusion.…”

“…El REBOA se utiliza habitualmente como complemento de la reanimación y como puente para el control definitivo de la hemorragia no compresible del torso en pacientes con shock hemorrágico 6 , 7 . También se ha implementado en pacientes con choque neurogénico para mantener la presión aórtica central necesaria para la perfusión cerebral, coronaria y de la médula espinal 8 .…”