Zone 1 or 3? Approach to Zone Selection and Pitfalls of REBOA Placement in Trauma

Abstract

The use of resuscitative endovascular balloon occlusion of the aorta (REBOA) in cases of non-compressible torso hemorrhage is becoming increasingly more common. While prospective multicenter data is being collected, and case reports are many, there is still significant debate on the ideal place for REBOA in critically ill trauma patients. With each application of the technique, there are opportunities for lessons learned and opportunities to inform other users while consensus in the trauma community is obtained. We report on the successful use of REBOA for the management of hemorrhagic shock and discuss several such lessons that may improve outcomes in future patients.

Keywords

• Trauma
• Hemorrhage; Shock
• Proximal Control
• REBOA
• Zone 1
• Zone 3