The end of balloons? Our take on the UK-REBOA trial

Author:

Brede Jostein RødsethORCID,Rehn Marius

Abstract

Abstract Background Resuscitative endovascular balloon occlusion of the aorta (REBOA) is increasingly used. The recently published UK-REBOA trial aimed to investigate patients suffering haemorrhagic shock and randomized to standard care alone or REBOA as adjunct to standard care and concludes that REBOA may increase the mortality. Main body In this commentary we try to balance the discussion on use of REBOA and address limitations in the UK-REBOA trial that may have influenced the outcome of the study. Conclusion The situation is complex, and the patients are in extremis. In summary, we do not think this is the end of balloons.

Publisher

Springer Science and Business Media LLC

Subject

Critical Care and Intensive Care Medicine,Emergency Medicine

Reference26 articles.

1. Brenner M, Bulger EM, Perina DG, Henry S, Kang CS, Rotondo MF, et al. Joint statement from the American College of Surgeons Committee on Trauma (ACS COT) and the American College of Emergency Physicians (ACEP) regarding the clinical use of Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA). Trauma Surg Acute Care Open. 2018;3(1):154.

2. RibeiroJunior MAF, Feng CYD, Nguyen ATM, Rodrigues VC, Bechara GEK, de-Moura RR, et al. The complications associated with Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA). World J Emerg Surg. 2018;13(1):20.

3. Joseph B, Zeeshan M, Sakran JV, Hamidi M, Kulvatunyou N, Khan M, et al. Nationwide analysis of resuscitative endovascular balloon occlusion of the aorta in civilian trauma. JAMA Surg. 2019;154(6):500–8.

4. Jansen JO, Hudson J, Cochran C, MacLennan G, Lendrum R, Sadek S, et al. Emergency Department resuscitative endovascular balloon occlusion of the aorta in trauma patients with exsanguinating hemorrhage: the UK-REBOA randomized clinical trial. JAMA. 2023. https://doi.org/10.1001/jama.2023.20850.

5. Karim Brohi [@karimbrohi]. UK-REBOA results: REBOA increased mortality at 90 days and at all interim time points. REBOA increased deaths due to bleeding at 3 hours and 90 days. REBOA substantially delayed time to definitive haemorrhage control. #ccr23 https://t.co/yGPoDTJC0Z [Internet]. Twitter. 2023 [cited 18 September 2023]. Tilgjengelig på: https://twitter.com/karimbrohi/status/1668900543270404096.

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