Digital illustration of a trauma scene highlighting REBOA intervention.

REBOA: A Lifeline for Trauma Patients?

Kai Mendoza in Health & Wellness December 2025 • 4 min read.

"Discover how resuscitative endovascular balloon occlusion of the aorta (REBOA) can improve outcomes in hemodynamically unstable patients with multiple severe torso trauma."

In the fast-paced world of emergency medicine, trauma management continues to evolve, integrating new technologies and strategies to improve patient outcomes. Among these innovations, resuscitative endovascular balloon occlusion of the aorta (REBOA) has emerged as a promising technique for managing severe hemorrhagic shock, particularly in patients with multiple torso injuries.

REBOA involves the temporary occlusion of the aorta using a balloon catheter, aiming to redistribute blood flow to vital organs and stabilize hemodynamically unstable patients. While the concept is relatively straightforward, the application and effectiveness of REBOA in complex trauma scenarios remain a topic of ongoing research and debate.

A recent retrospective study by Otsuka et al. delves into the impact of REBOA on patients with severe multiple torso trauma, providing valuable insights into its potential benefits and limitations. Published in the World Journal of Emergency Surgery, this research seeks to clarify the role of REBOA in improving survival rates and optimizing trauma management strategies.

What is REBOA and How Does It Work?

Digital illustration of a trauma scene highlighting REBOA intervention.

REBOA is a minimally invasive technique used in emergency situations to control severe bleeding. A balloon catheter is inserted into the femoral artery and advanced into the aorta, where it is inflated to temporarily block blood flow. This occlusion helps to increase blood pressure to the brain and heart, buying time for definitive hemorrhage control measures to be implemented.

The study by Otsuka et al. retrospectively analyzed data from 5,899 severe trauma patients admitted to a hospital between January 2011 and January 2018. The researchers focused on 107 patients with severe torso trauma (Injury Severity Score > 16) who displayed persistent hypotension despite initial resuscitation efforts. These patients were divided into two groups: those managed with REBOA (n = 15) and those managed without REBOA (n = 92).

In-hospital mortality: The primary endpoint was the effectiveness of REBOA in reducing in-hospital mortality.
Time to hemostasis: Secondary endpoints included the time from admission to the start of hemostasis, an important factor in trauma management.
Statistical Analysis: Multivariable logistic regression analysis was used to evaluate clinical outcomes, adjusting for clinically important variables.

The results of the study indicated that trauma management with REBOA was significantly associated with decreased mortality. The adjusted odds ratio of survival was 7.430 (95% confidence interval, 1.081–51.062; p = 0.041). However, the time from admission to initiation of hemostasis was not significantly different between the two groups. The average time from arrival to balloon occlusion was 55.7 ± 34.2 minutes, with a total balloon occlusion time of 32.5 ± 18.2 minutes.

Navigating REBOA: A Path Forward

The study underscores that REBOA, when integrated with rapid resuscitative hemostasis, can improve outcomes in patients with severe torso trauma. However, it also highlights the need for judicious use to avoid potential complications. Future research should focus on refining patient selection criteria and optimizing the timing and technique of REBOA to maximize its benefits.

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Everything You Need To Know

What is REBOA and how is it used in trauma management?

REBOA, or resuscitative endovascular balloon occlusion of the aorta, is a minimally invasive technique used to manage severe bleeding in trauma patients. A balloon catheter is inserted into the femoral artery and advanced into the aorta. The balloon is then inflated to temporarily block blood flow, redistributing it to vital organs like the brain and heart. This process helps stabilize hemodynamically unstable patients, allowing time for definitive hemorrhage control measures to be implemented. The goal is to improve survival rates in severe trauma cases by controlling blood loss and maintaining perfusion to critical organs.

How does the study by Otsuka et al. contribute to understanding the effectiveness of REBOA?

The study by Otsuka et al. provides valuable insights into the impact of REBOA in patients with severe multiple torso trauma. The research retrospectively analyzed data from 5,899 severe trauma patients and focused on a subset of 107 patients with severe torso trauma. This study compared outcomes between patients managed with REBOA and those managed without it. The study found that REBOA was significantly associated with decreased mortality. The analysis evaluated in-hospital mortality, time to hemostasis and other factors to assess the clinical effectiveness of REBOA, supporting the judicious use of REBOA.

What are the potential benefits of using REBOA for severe torso trauma?

The primary benefit of using REBOA in severe torso trauma is the potential to improve survival rates. REBOA can quickly control severe bleeding by temporarily occluding the aorta, which helps stabilize hemodynamically unstable patients. By redistributing blood flow to vital organs, REBOA provides time for the medical team to implement definitive hemorrhage control measures. As the study results indicated, it can significantly decrease mortality. However, the use of REBOA should be integrated with rapid resuscitative hemostasis to achieve optimal outcomes.

What are the key findings of the study regarding the use of REBOA in trauma patients, including the time factors?

The study's key finding is that REBOA use was significantly associated with decreased mortality in patients with severe torso trauma. The adjusted odds ratio of survival was 7.430 (95% confidence interval, 1.081–51.062; p = 0.041). The time from admission to initiation of hemostasis was not significantly different between the REBOA and non-REBOA groups. The average time from arrival to balloon occlusion was 55.7 ± 34.2 minutes. The total balloon occlusion time was 32.5 ± 18.2 minutes. These time-related factors are critical in the context of trauma management, as rapid intervention is key to improving patient outcomes.

What are the limitations or considerations surrounding the use of REBOA in trauma management?

While REBOA shows promise, its use involves considerations. Future research should focus on refining patient selection criteria and optimizing the timing and technique to maximize its benefits. One limitation is the need for judicious use to avoid potential complications, which are not detailed within the provided text. The study by Otsuka et al. highlights the importance of integrating REBOA with rapid resuscitative hemostasis. The effectiveness of REBOA is dependent on several factors, including the severity of the trauma, the expertise of the medical team, and the specific approach used to achieve hemostasis. Therefore, REBOA is not a universal solution, and its application must be carefully considered and tailored to the individual patient's condition.