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REBOA

Sunnybrook uses COBRA-OS® as our REBOA device

Video showing insertion technique


  • There is no high-grade evidence defining the specific indications for the use of REBOA.
  • REBOA may be used for traumatic life-threatening hemorrhage below the diaphragm in patients in hemorrhagic shock who are refractory to resuscitation.
  • REBOA does not confer any long-term survival advantage when used in traumatic cardiac arrest compared with standard of care.
  • REBOA is contraindicated in the setting of major thoracic hemorrhage or pericardial tamponade. Use of REBOA in the setting of thoracic great vessel injury is limited to case reports where open thoracotomy and/or sternotomy is performed in conjunction with REBOA. In these situations, open thoracic exposure is performed to obtain immediate proximal control of hemorrhage although aortic balloon occlusion is utilized for resuscitation.
  • There is insufficient data to make specific recommendations about REBOA use in the pediatric or geriatric populations; REBOA may have increased risks in these populations. Further study is needed in these patient populations.

Bulger EM, Perina DG, Qasim Z, Beldowicz B, Brenner M, Guyette F, Rowe D, Kang CS, Gurney J, DuBose J, Joseph B, Lyon R, Kaups K, Friedman VE, Eastridge B, Stewart R. Clinical use of resuscitative endovascular balloon occlusion of the aorta (REBOA) in civilian trauma systems in the USA, 2019: a joint statement from the American College of Surgeons Committee on Trauma, the American College of Emergency Physicians, the National Association of Emergency Medical Services Physicians and the National Association of Emergency Medical Technicians. Trauma Surg Acute Care Open. 2019 Sep 20;4(1):e000376. doi: 10.1136/tsaco-2019-000376. PMID: 31673635; PMCID: PMC6802990.



Original.00000539-201709000-00001.FU1.jpegWanderer, Jonathan P. MD, MPhil; Nathan, Naveen MD. A Graphical Guide to the REBOA: Five Life-Saving Steps. Anesthesia & Analgesia: September 2017 - Volume 125 - Issue 3 - p 715
doi: 10.1213/ANE.0000000000002310 


  Sridhar, Srikanth MD*; Gumbert, Sam D. MD*; Stephens, Christopher MD*; Moore, Laura J. MD†; Pivalizza, Evan G. MBChB, FFASA*. Resuscitative Endovascular Balloon Occlusion of the Aorta: Principles, Initial Clinical Experience, and Considerations for the Anesthesiologist. Anesthesia & Analgesia: September 2017 - Volume 125 - Issue 3 - p 884-890
doi: 10.1213/ANE.0000000000002150 


 Qasim, Zaffer A. MBBS, FRCEM, FRCPC, EDIC*; Sikorski, Robert A. MD†. Physiologic Considerations in Trauma Patients Undergoing Resuscitative Endovascular Balloon Occlusion of the Aorta. Anesthesia & Analgesia: September 2017 - Volume 125 - Issue 3 - p 891-894
doi: 10.1213/ANE.0000000000002215

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