The Role of Prehospital REBOA for Hemorrhage Control in Civilian and Military Austere Settings: A Systematic Review
Trauma Care · 2022-02-25 · Systematic review
Abstract
Despite the success of prehospital resuscitative endovascular balloon occlusion of the aorta (REBOA) in combat and civilian settings, the prevalence of complications and the lack of conclusive evidence has led to uncertainty and controversy. Therefore, this systematic review aimed to evaluate the role of prehospital REBOA for hemorrhage control in trauma populations. We systematically searched Cochrane, Ovid MEDLINE, EMBASE and Google Scholar for all relevant studies that investigated the efficacy of prehospital REBOA on trauma patients with massive hemorrhage. Primary outcome was evaluated by blood pressure elevation and secondary outcome was measured by 30-day mortality and complications. Our search identified 546 studies, but only six studies met the inclusion and exclusion criteria. Included studies were low to moderate quality due to limitations within the studies. However, all of the studies reported significant elevation of blood pressure and survival, demonstrating the potential benefits of REBOA. For example, the 30-day mortality rate reduced significantly after REBOA, but studies lacked long-term outcome assessments across the continuum of care. Due to the heterogeneity of the results, a meta-analysis was not possible. We conclude that prehospital REBOA is a feasible and effective resuscitative adjunct for shock patients with lethal non-compressible torso hemorrhage. However, due to the unclear causes of complications and the lack of high quality and homogeneous data, the effects of prehospital REBOA were not truly reflected and comparison between groups was not feasible. Thus, further high-quality studies are required to attest the causality between prehospital REBOA and outcomes.
Abstract © the authors or publisher, via OpenAlex. Reuse and removal
Tags
Military & tactical · Mortality & survival · REBOA
Related articles
- Prehospital Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) in Patients with Major Trauma and Cardiac Arrest: A Systematic Review. (Prehosp Emerg Care, 2026)
- Resuscitative Endovascular Balloon Occlusion of the Aorta in surgical and trauma patients: a systematic review, meta-analysis and practice management guideline from the Eastern Association for the Surgery of Trauma. (Trauma Surg Acute Care Open, 2025)
- Use of Haemostatic Devices for the Control of Junctional and Abdominal Traumatic Haemorrhage: A Systematic Review (Trauma Care, 2022)
- Use of Zone 1 REBOA in Deployed U.S. Military Settings Is Associated With Improved Survival to Next Role of Care. (Mil Med, 2026)
- A Modern Case Series of Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) in an Out-of-Hospital, Combat Casualty Care Setting. (J Spec Oper Med, 2017)
- Resuscitative endovascular balloon occlusion of the aorta: a gap analysis of severely injured UK combat casualties. (Shock, 2014)