Emergency Department Resuscitative Endovascular Balloon Occlusion of the Aorta in Trauma Patients With Exsanguinating Hemorrhage: The UK-REBOA Randomized Clinical Trial

Methodology: 2/5
Usefulness: 2/5

Jansen JO, et al. JAMA. 2023 Oct 12:e2320850.

Editorial: Contemporary Adjuncts to Hemorrhage Control.

Question and Methods: Multi-center pragmatic Bayesian RCT comparing 90d all-cause mortality and 10 secondary outcomes in trauma patients with hemorrhage receiving REBOA + standard of care vs. standard of care alone
Findings: At 90d, 54% of patients in the REBOA group had experienced all-cause mortality vs. 42% of patients in the standard care group (OR 1.58 [95% credible interval, 0.72-3.52])
Limitations: Trial stopped early due to evidence of harm in REBOA group, no standardization of REBOA equipment manufacturer or size, low overall number of REBOA deployments (19) over the 4.5 yr study period.

Interpretation: In low-volume trauma centers, exsanguinating trauma patients should receive standard of care, rather than REBOA. We cannot wholly discredit the utility of REBOA based on this single RCT.

By: Dr. Thariq Badiudeen

JC Supervisor: Dr. Venkatesh Thiruganasmabandamoorthy

Authors

Thariq Badiudeen

MD, MSc

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Hans Rosenberg

Dr. Rosenberg is an emergency physician at the Ottawa Hospital, associate professor at the University of Ottawa, and Director of the Digital Scholarship and Knowledge Dissemination Program.

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Venkatesh Thiruganasambandamoorthy

Dr. Venkatesh Thiruganasambandamoorthy is an attending physician and associate scientist at the Ottawa Hospital and Ottawa Hospital Research Institute with an particular interest in syncope and presyncope care.

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