REBOA for Refractory Pelvic Hemorrhage: Preventing Mortality in Potentially Survivable Death after Trauma

REBOA has been recently adopted for trauma patients with refractory hypotension or in traumatic arrest from hemorrhage below the diaphragm. REBOA has shown improved physiologic parameters, coronary and cerebral blood flow, and survival in hemorrhage models. The National Trauma Care System (NTCS) goal to achieve zero preventable deaths after injury may benefit with advances in REBOA. Non-compressible hemorrhages have been found to contribute significantly to the potentially survivable combat deaths in the wars in Iraq and Afghanistan and REBOA has indications for use in non-compressible he-morrhage below the diaphragm. Recognition that indications for REBOA are present in potentially survivable deaths after injury is the driving force behind its evolution and in alignment with the goals of the NTCS. This case report is an example of REBOA use, by a military trauma surgeon working in the civilian setting, on a patient in refractory hemorrhagic shock secondary to blunt trauma and pelvic hemorrhage with a positive outcome.