Arterial access:

In clinical situations where REBOA is being considered, early placement of an arterial line in the common femoral artery (CFA) is recommended. CFA access has consistently been identified as the rate limiting step to REBOA deployment.32 Obtaining early CFA access in the form of an arterial line can greatly decrease REBOA placement time: an existing common femoral arterial line can quickly be re-wired and upsized to a 4 - 7 Fr sheath (depending on what system is used) for REBOA in the event of patient deterioration. It can also be used to transduce the distal SBP with the pREBOA-PRO™ partially inflated.

Goal proximal SBP in REBOA is between 90 - 110 mmHg. If there is concern for traumatic brain injury a SBP > 110 mmHg has been advocated (See the JTS CPG Traumatic Brain Injury and Neurosurgery in the Deployed Environment CPG).53 If utilizing (MAP goals instead of SBP, it is recommended to maintain MAP of 55 - 65 mmHg proximal to the balloon. Only after that range is achieved does the user consider if the patient's physiology requires partial or complete occlusion.