Partial resuscitative endovascular balloon occlusion of the aorta as a resuscitative strategy in traumatic hemorrhagic shock: A retrospective analysis of a Chinese single-center cohort.

PURPOSE: To evaluate the clinical outcomes of partial resuscitative endovascular balloon occlusion of the aorta (p-REBOA) in trauma patients with hemorrhagic shock.

METHODS

A retrospective analysis was conducted on traumatic hemorrhagic shock patients managed with p-REBOA (using a blood pressure-guided strategy to maintain 90-100/60-70 mmHg) in the emergency department of a Class A Tertiary Hospital from January 2020 to December 2024. The primary outcome was 90 day survival. Key secondary variables included hemodynamic parameters, REBOA procedural details, and complications. Continuous data are presented as mean ± standard deviation or median (Q1, Q3) depending on distribution; categorical data as n (%). Group comparisons were performed using χ2 or Fisher's exact tests for categorical variables and t-tests or Mann-Whitney U tests for continuous variables.

RESULTS

Fifty-two patients with traumatic hemorrhagic shock were enrolled, among whom 21 died, and 31 survived. All patients were critically injured, with an injury severity score of 26 (16, 35) and the median Glasgow coma scale of 8 (3, 15). All patients presented with shock-related syndromes, and the median p-REBOA operation time was 14 (10, 20) min. After p-REBOA, blood pressure increased from 74 ± 18/44 ± 11 mmHg on admission to 100 ± 21/58 ± 14 mmHg. Shock-induced effects on pH and lactate levels resolved 24 h after p-REBOA; 48 people underwent damage control surgery after p-REBOA. Trauma-induced coagulopathy, pulmonary infection, and shock-related liver/kidney injuries were the most common complications. Patients with concomitant injuries (brain and thoracic) had a significantly lower survival rate than those with isolated injuries.

CONCLUSION

With blood pressure maintained at 90 - 100/60 - 70 mmHg as a guideline, the use of non-compliant balloon catheters for p-REBOA in trauma patients suffering hemorrhagic shock offers enhanced hemodynamic stability, fewer p-REBOA-associated complications, and higher survival rates. However, implementing p-REBOA in polytrauma patients with concomitant craniocerebral and thoracic injuries warrants cautious evaluation.