The role of resuscitative endovascular balloon occlusion of the aorta in the tactics of damage control

Resuscitative endovascular balloon occlusion of the aorta is an innovative method for temporarily stopping bleeding in injuries of the abdomen and pelvis. The frequency of this method is increasing every year. Meanwhile, the effects of aortic balloon occlusion on hemodynamics and body physiology are not well understood, and its role in the injury control strategy remains ambiguous. The review considers the tactics, effectiveness and dangers of using aortic balloon occlusion in trauma based on the results of recent clinical and experimental studies. Aortic balloon occlusion is effective in haemodynamic stabilization in patients with abdominal and / or pelvic trauma with ongoing bleeding and has priority over resuscitation thoracotomy with aortic clamping. The use of aortic balloon occlusion is associated with the risk of dangerous complications associated with arterial access and balloon placement in the aorta, ischemia and reperfusion. Aortic occlusion can increase bleeding from damaged hepatic veins, chest vessels, brain; increase intracranial pressure. Methods of partial and intermittent balloon occlusion of the aorta can prolong aortic occlusion with significantly less consequences of the reperfusion syndrome and reduce the risk of death. Improvement in the results of the use of aortic balloon occlusion can be achieved in trauma centers that perform more than 10 interventions per year, using a hybrid tactic for the treatment of severe injuries with proactive early access to the artery in patients with unstable hemodynamics.