Resuscitative Endovascular Balloon Occlusion of Aorta (REBOA) is indicated to be used in exsanguinating pelvic fractures not responsive to fluid resuscitation. In primary survey, there has been no less invasive and effective means to stop internal non-compressible bleeding in exsanguinating pelvic fractures. Before the introduction of REBOA, the patients can only be managed by the following ways with their respective limitations:
- Fluid resuscitation and blood transfusion: these are not targeted on hemorrhage control but circulation replenishment which is recently proven to be harmful
- Application of pelvic binder: this is with limited efficacy
- Cross-clamping of descending aorta through thoracotomy wound for bleeding control: this is seldom practiced locally
Those non-responders or partial responders to fluid resuscitation cannot be saved or suffered from a stormy postoperative course in ICU with significant mortality because of massive blood loss and blood products transfusion. REBOA can have temporary control of bleeding for initial assessment and resuscitation and buy time for effective surgical planning and definitive treatment. The procedure of REBOA is to be performed on the resuscitative table in AED resuscitation room for initial bleeding control, followed by definitive treatment including 3-in-1 procedures in the operation theatre. Current evidence from the literature supports the use of REBOA. Training courses for designated operators have been organized before patient use, in order to ensure safety and minimize potential complications of the procedure.
Co-location with:
