Aortic Occlusion with REBOA Reverses Cerebral Ischaemia Induced by Haemorrhagic Shock

Background In recent years, the use of Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) as a less invasive procedure compared to aortic cross-clamping via thoracotomy (1) has increased as an adjunct resuscitative method and a bridge to damage control surgery, primarily in trauma settings involving haemodynamically unstable patients (2-4). The main function of REBOA in HS is to preserve the remaining blood to the upper part of the body, i.e. to the brain, the lungs, and the heart. Additionally, REBOA reduces ongoing bleeding distal to the occlusion until definitive haemostasis is achieved (5). REBOA increases blood pressure proximal to the occlusion zone (proximal mean arterial pressure (pMAP)); consequently, it might be lifesaving and mitigates cerebral damage and neurological sequelae following the reduction of cerebral perfusion in patients with HS (6, 7).