Why do we care?
Is this REBOA thing new?!
How do I put in a REBOA?
|CODA Balloon Catheter|
|REBOA in Zone I|
|PRYOR MEDICAL Prytyme ER-REBOA Catheter|
Changes to the new design include, but are not limited to:
- More rigidity and thus guidewire-free
- Requires only a 7F introducer sheath eliminating the need for arterial repair on removal
- A protective “p-tip” to avoid vascular injury on insertion
- External landmarks for more accurate placement without additional equipment and a proximal arterial line port in order to accurately measure blood pressure following balloon inflation.
Does REBOA work?
Who gets REBOA?As with many invasive procedures in critically ill patients (eg. ECMO), the million dollar question really is who gets REBOA. Trauma centres in both Denver (from manuscript; below) and Baltimore (below; widely available on internet) have proposed various algorithms in order to determine who gets REBOA in the trauma bay, and where REBOA should be placed (ie. Zone I vs Zone III)
It’s not all roses…
- increased IL-6 levels
- increased norepinephrine requirements for hemodynamic instability
- increased incidence of ARDS.