Introduction: Currently, Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) is gaining prominence over time as adjunctive management for Non-Compressible Torso Hemorrhage (NCTH). However, in resource-limited situations, such as disasters, there is still relatively little information about this procedure. This study intended to determine the feasibility of REBOA in NCTH patients, factors related to survival, the following complications, and the feasibility of performing the procedure with limited resources. Methods: 23 NCTH patients treated with REBOA without fluoroscopic machine confirmation of the balloon position in the ER at the Trauma Center Khon Kaen University, were retrospectively reviewed from 2012 to 2013. The ascertained survival rate after the procedure and 28 days of mortality are the primary outcomes, while associated factors and complications are secondary outcomes. Results: Among NCTH patients undergoing REBOA, the survival rate after the procedure was 26.09% (n=6), and 28 days afterward was 21.74% (n=5). There were significant differences in the Glasgow Coma Scale (GCS) scores upon arrival between the survival group (SG) and non-survival group (NSG) after the procedure. The median GCS was 11 for the SG and 3 for the NSG (OR 1.76, p=0.024). At 28 days, the only statistically significant results were found in the GCS range of 10-12, with 3 survivors (75.00%) versus 3 non-survivors (15.79%) (OR 16, p=0.035). 10 patients experienced prehospital CPR (43.48%) but did not survive. 7 patients underwent CPR during REBOA, one of them stayed after the procedure but died 28 days afterward. The complications were bleeding 65.22% (n=15), and acute kidney injury 21.74% (n=5). Conclusion: Among NCTH trauma patients undergoing REBOA, approximately a quarter had survived after REBOA and primary operative procedure, and slightly lower at 28 days after injury. This procedure can be safely performed by an experienced surgeon under a limited resource situation.
Jeerasuwannakul et al. (Sun,) studied this question.