• Partial REBOA is conditionally preferred over complete REBOA. This requires training of all surgical and damage control resuscitation team personnel and acquisition of the partial occlusion device. The pREBOA-PRO™ catheter is currently the only FDA-approved catheter for partial aortic occlusion.
• For accurate titration of partial REBOA, central arterial blood pressure should be measured above and below the balloon, this requires a two arterial line transducer set up. A target central aortic SBP of 90-110 mmHg above the balloon, and minimum pulsatile SBP of 20 mmHg below the balloon, while titrating distal pressure to a target systolic blood pressure of 20 - 50 mmHg is desirable in partial occlusion.⁴⁹ Of note: the pREBOA-PRO™ catheter provides the ability to measure above and below the catheter without additional access.
• Partial aortic occlusion of Zone 1 should ideally be limited to 2 hours, and Zone 3 should be limited to 4 hours. This continues to be an active area of clinical and animal research at the time of publication of this CPG.
• Complete aortic occlusion should be limited to less than 60 minutes in Zone 1, optimally < 30 minutes. When placed in Zone 3, keep RAO < 60 minutes.