engleski

REBOA in Non-traumatic Cardiac Arrest - A Life- Saving Balloon or Just a Bunch of Hot Air?

INTRODUCTION: Resuscitative endovascular balloon occlusion of the aorta (REBOA) is a novel method of hemorrhage control that temporarily occludes the aorta, either partially or completely. In recent years, several groups of authors have found another potential use for REBOA - supplementing conventional advanced cardiac life support (ACLS) in non-traumatic arrest by occluding the proximal aorta and redistributing blood flow to the coronary and cerebral vasculature. This review aims to evaluate the available evidence on REBOA in the management of non-traumatic cardiac arrest. MATERIALS AND METHODS: A literature search of the MEDLINE, Web of Science, and Google Scholar databases has been performed using the keywords “REBOA”, “cardiac arrest”, “non-traumatic” and “medical”. Articles not concerning the use of REBOA in non-traumatic cardiac arrest management have been excluded. RESULTS: The search yielded 3 animal studies, 1 needs assessment analysis, 2 case reports, 1 case series, and 3 feasibility/pilot studies on humans. The animal studies were all performed on porcine models of cardiac arrest and demonstrated an increase in both coronary and cerebral perfusion pressures with REBOA. The case reports/case series described non-traumatic out-of-hospital cardiac arrest (OHCA) patients in which conventional ACLS was ineffective, some of which had improved outcomes with REBOA. The feasibility studies demonstrated that REBOA is feasible in OHCA, with success rates of catheter placement being 100% and return of spontaneous circulation (ROSC) being achieved in 60% of patients. CONCLUSION: REBOA is a feasible and prospective supplement to conventional ACLS for the management of OHCA. Larger studies should be performed to clarify the optimal patient selection criteria and variables that affect the success rate of achieving ROSC or improved neurologically intact survival.

Balloon occlusion ; Cardiac arrest ; Emergency medicine ; Return of spontaneous circulation

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