Resuscitative endovascular balloon occlusion of aorta (REBOA): expanding the window of survival in massive bleeding

Exsanguinating hemorrhage is responsible for 30 to 40% of early deaths from trauma and most of these deaths occur within the first few hours of injury 1. A study by A. Alarhyem et al. in 2016 revealed a precipitous rise in trauma deaths in victims with high grade injuries with pre-hospital time <30 min 2.The tenet of limiting time at the scene with rapid transport to definitive care (scoop and run) within this time frame is unrealistic and requires a different approach. It was estimated that nearly half of the deaths in the resuscitation room of the National Hospital of Sri Lanka are due to unattended exsanguination from trauma to the torso. An immediate intervention to stop exsanguination from torso trauma has been the focus for several decades. Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) is being explored primarily for this purpose. Advancing this novel strategy to trauma victims in the early phase of care may expand the window of survival to definitive care.