Hate to burst your balloon: Successful reboa use takes more than a course

Christina M. Theodorou, Edgardo S. Salcedo, Joseph J. Dubose, Joseph M. Galante

Research output: Contribution to journalArticlepeer-review

2 Scopus citations

Abstract

Background: Resuscitative endovascular balloon occlusion of the aorta (REBOA) is emerging as a viable interven-tion for hemorrhagic shock. Training surgeons to place the device is only part of the process. We hypothesize that implementation challenges extend beyond surgical skills training and initial REBOA use should not be expected to mirror published success. Methods: All REBOA placements from January 2016 to February 2017 at a level 1 trauma center were reviewed for opportunities for improvement. From September 2016 to February 2017, all patients meeting highest trauma activa-tion criteria were reviewed against our REBOA algorithm to identify patients meeting criteria for REBOA placement but not undergoing the procedure. Results: REBOA was introduced at our institution in September 2015, with the first placement in January 2016. Trauma surgery, emergency department, and operating room staff underwent training. Nine patients had REBOA placed with six survivors. One patient underwent an unsuccessful REBOA attempt and died. Four patients had complications from REBOA. Eight additional patients met indications but did not undergo REBOA. Conclusions: Successful REBOA use requires more than teaching surgeons indications and techniques. For a successful REBOA program, system factors must be addressed. System processes must ensure equipment and procedures are standardized and familiar to all involved. Complications should be expected.

Original languageEnglish (US)
Pages (from-to)21-29
Number of pages9
JournalJournal of Endovascular Resuscitation and Trauma Management
Volume4
Issue number1
DOIs
StatePublished - 2020

Keywords

  • Algorithm
  • Implementation
  • REBOA
  • Trauma

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine
  • Emergency Medicine
  • Surgery

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