Table 2

Partial REBOA rollout collaborative institutional algorithms for REBOA patient selection

InstitutionData sources citedTrigger for early CFA accessContraindications to REBOACriteria for REBOA patient selection
Ernest E Moore Shock Trauma Center at Denver Health (Denver, Colorado)No
  • SBP <100: 5Fr.

  • SBP <90: 7Fr.

  • SBP <80: REBOA.

  • Active thoracic bleeding.

  • SBP <80 and cavitary triage.

Grady Memorial Hospital (Atlanta, Georgia)No
  • Concern for truncal hemorrhage.

  • SBP <90, received 2 units of blood product, or transient transponder.

  • Not specified.

  • SBP <90.

  • Transient responder to resuscitation.

  • Non-responder to 2 units of blood.

  • Traumatic cardiac arrest.

Grant Medical Center (Columbus, Ohio)No
  • SBP <90.

  • Transient responder.

  • Profound, refractory shock.

  • OHCA with ROSC.

  • Not specified.

  • SBP <90 with inadequate response to resuscitation.

  • Profoundly hypotensive.

  • Hypovolemic cardiac arrest and not beyond salvage.

University of Maryland Shock Trauma Center (Baltimore, Maryland)No
  • None specified.

  • Not specified.

  • Persistently hypotensive or transient responder.

  • Low suspicion for aortic injury.

  • Evidence of vascular continuity from CFA to thoracic aorta.

  • Attending trauma surgeon or intensivist discretion.

St Michael’s Hospital (Toronto, Ontario)Yes
  • Pelvic fracture.

  • Positive FAST and SBP <90.

  • Not specified.

  • Traumatic arrest for abdominal/pelvic/junctional hemorrhage provided reversible cause suspected.

  • SBP <90 and transient or non-responder with positive abdominal FAST or pelvic X-ray (blunt) or abdominal/pelvic/junctional injury (penetrating).

University Medical Center New Orleans (New Orleans, Louisiana)Yes
  • SBP <90 and partial or non-responder.

  • Blunt: possible aortic injury on CXR.

  • Penetrating: possible supradiaphragmatic or cardiac injury.

  • Blunt: SBP <90 and partial or non-responder.

  • Penetrating: SBP <90 and truncal/lower extremity injury (in OR).

  • In OR: SBP <90, transient responder, profound refractory shock, or prehospital CPR with ROSC.

Vanderbilt University Medical Center (Nashville, Tennessee)No
  • SBP <80 with a pulse.

  • Thoracic aortic injury.

  • Transient or non-responder.

  • CFA, common femoral artery; CPR, cardiopulmonary resuscitation; CXR, chest X-ray; FAST, focused assessment with sonography in trauma; Fr, French; OHCA, out of hospital cardiac arrest; OR, operating room; REBOA, resuscitative endovascular balloon occlusion of the aorta; ROSC, return of spontaneous circulation; SBP, systolic blood pressure.