The use of resuscitative endovascular balloon occlusion of the aorta (REBOA) for non‐traumatic cardiac arrest: A review

Abstract Resuscitative endovascular balloon occlusion of the aorta (REBOA) has been proposed as a novel approach to managing non‐traumatic cardiac arrest (NTCA). During cardiac arrest, cardiac output ceases and perfusion of vital organs is compromised. Traditional advanced cardiac life support (ACLS...

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Main Authors: Craig D. Nowadly, M. Austin Johnson, Guillaume L. Hoareau, James E Manning, James I. Daley
Format: Article
Language:English
Published: Elsevier 2020-10-01
Series:Journal of the American College of Emergency Physicians Open
Subjects:
Online Access:https://doi.org/10.1002/emp2.12241
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author Craig D. Nowadly
M. Austin Johnson
Guillaume L. Hoareau
James E Manning
James I. Daley
author_facet Craig D. Nowadly
M. Austin Johnson
Guillaume L. Hoareau
James E Manning
James I. Daley
author_sort Craig D. Nowadly
collection DOAJ
description Abstract Resuscitative endovascular balloon occlusion of the aorta (REBOA) has been proposed as a novel approach to managing non‐traumatic cardiac arrest (NTCA). During cardiac arrest, cardiac output ceases and perfusion of vital organs is compromised. Traditional advanced cardiac life support (ACLS) measures and cardiopulmonary resuscitation are often unable to achieve return of spontaneous circulation (ROSC). During insertion of REBOA a balloon‐tipped catheter is placed into the femoral artery and advanced in a retrograde manner into the aorta while the patient is undergoing cardiopulmonary resuscitation (CPR). The balloon is then inflated to fully occlude the aorta. The literature surrounding the use of aortic occlusion in non‐traumatic cardiac arrest is limited to animal studies, case reports and one recent non‐controlled feasibility trial. In both human and animal studies, preliminary data show that REBOA may improve coronary and cerebral perfusion pressures and key physiologic parameters during cardiac arrest resuscitation, and animal data have demonstrated improved rates of ROSC. Multiple questions remain before REBOA can be considered as an adjunct to ACLS. If demonstrated to be effective clinically, REBOA represents a potentially cost‐effective and generalizable intervention that may improve quality of life for patients with non‐traumatic cardiac arrest.
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spelling doaj-art-3d559d4bde594523ab10054c9bbda7992025-08-20T02:00:37ZengElsevierJournal of the American College of Emergency Physicians Open2688-11522020-10-011573774310.1002/emp2.12241The use of resuscitative endovascular balloon occlusion of the aorta (REBOA) for non‐traumatic cardiac arrest: A reviewCraig D. Nowadly0M. Austin Johnson1Guillaume L. Hoareau2James E Manning3James I. Daley4Department of Emergency Medicine David Grant United States Air Force Medical Center Travis Air Force Base Sacramento California USADivision of Emergency Medicine University of Utah School of Medicine Salt Lake City Utah USADivision of Emergency Medicine University of Utah School of Medicine Salt Lake City Utah USADepartment of Emergency Medicine University of North Carolina School of Medicine Chapel Hill USADepartment of Emergency Medicine Yale University School of Medicine New Haven Connecticut USAAbstract Resuscitative endovascular balloon occlusion of the aorta (REBOA) has been proposed as a novel approach to managing non‐traumatic cardiac arrest (NTCA). During cardiac arrest, cardiac output ceases and perfusion of vital organs is compromised. Traditional advanced cardiac life support (ACLS) measures and cardiopulmonary resuscitation are often unable to achieve return of spontaneous circulation (ROSC). During insertion of REBOA a balloon‐tipped catheter is placed into the femoral artery and advanced in a retrograde manner into the aorta while the patient is undergoing cardiopulmonary resuscitation (CPR). The balloon is then inflated to fully occlude the aorta. The literature surrounding the use of aortic occlusion in non‐traumatic cardiac arrest is limited to animal studies, case reports and one recent non‐controlled feasibility trial. In both human and animal studies, preliminary data show that REBOA may improve coronary and cerebral perfusion pressures and key physiologic parameters during cardiac arrest resuscitation, and animal data have demonstrated improved rates of ROSC. Multiple questions remain before REBOA can be considered as an adjunct to ACLS. If demonstrated to be effective clinically, REBOA represents a potentially cost‐effective and generalizable intervention that may improve quality of life for patients with non‐traumatic cardiac arrest.https://doi.org/10.1002/emp2.12241arrhythmias cardiaccardiopulmonary resuscitationendovascular proceduresheart arrestintra‐aortic balloon pumpingresuscitation
spellingShingle Craig D. Nowadly
M. Austin Johnson
Guillaume L. Hoareau
James E Manning
James I. Daley
The use of resuscitative endovascular balloon occlusion of the aorta (REBOA) for non‐traumatic cardiac arrest: A review
Journal of the American College of Emergency Physicians Open
arrhythmias cardiac
cardiopulmonary resuscitation
endovascular procedures
heart arrest
intra‐aortic balloon pumping
resuscitation
title The use of resuscitative endovascular balloon occlusion of the aorta (REBOA) for non‐traumatic cardiac arrest: A review
title_full The use of resuscitative endovascular balloon occlusion of the aorta (REBOA) for non‐traumatic cardiac arrest: A review
title_fullStr The use of resuscitative endovascular balloon occlusion of the aorta (REBOA) for non‐traumatic cardiac arrest: A review
title_full_unstemmed The use of resuscitative endovascular balloon occlusion of the aorta (REBOA) for non‐traumatic cardiac arrest: A review
title_short The use of resuscitative endovascular balloon occlusion of the aorta (REBOA) for non‐traumatic cardiac arrest: A review
title_sort use of resuscitative endovascular balloon occlusion of the aorta reboa for non traumatic cardiac arrest a review
topic arrhythmias cardiac
cardiopulmonary resuscitation
endovascular procedures
heart arrest
intra‐aortic balloon pumping
resuscitation
url https://doi.org/10.1002/emp2.12241
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