Future Considerations

A retrospective capability gap analysis of the UK Joint Theatre Trauma Registry suggested that as many as one in five severely injured casualties have wounds that may be amenable to treatment with REBOA.61 The development of the 7 Fr ER REBOA catheter facilitates insertion of the device and may lead to more widespread use of this approach in the austere environment. Training non-physician caregivers to place REBOAs in the prehospital settings is being investigated.62-63 Partial REBOA, intermittent REBOA, regional hypothermia, and pharmacologic adjuncts continue to undergo validation as a means of prolonging aortic occlusion time.60,39,64 Ongoing research seeks to identify modifications to the REBOA technique that may be required when it is combined with other resuscitation modalities such as tranexamic acid. Researchers are also striving to clarify patient selection, evaluating the impact of REBOA on thoracic injury, and traumatic brain injury.65 All of these advances should refine the optimal use of this resuscitation adjunct. Longitudinal data in the civilian and military setting will assist in defining the ideal clinical situation in which REBOA can be of maximal benefit.