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alternative modality in remote or austere environments where 5. Manley JD, Mitchell BJ, DuBose JJ, Rasmussen TE. A modern case
fluoroscopy is not available. As REBOA becomes more widely series of resuscitative endovascular balloon occlusion of the aorta
used outside the operating room, further research is needed to (REBOA) in an out-of-hospital, combat casualty care setting. J Spec
Oper Med. 2017;17(1):1–8.
ensure reliable placement to minimize morbidity and maximize 6. DuBose JJ, Scalea TM, Brenner M, et al. The AAST prospective Aor-
potential benefits. tic Occlusion for Resuscitation in Trauma and Acute Care Surgery
(AORTA) registry: data on contemporary utilization and outcomes of
aortic occlusion and resuscitative balloon occlusion of the aorta (RE-
Acknowledgments BOA). J Trauma Acute Care Surg. 2016;81(3):409–419.
The authors would like to thank Dr Christian McEvoy and 7. Stannard A, Eliason JL, Rasmussen TE. Resuscitative endovascular
Dr Shane Jensen for their helpful technical discussions and balloon occlusion of the aorta (REBOA) as an adjunct for hemor-
REBOA training. The authors would also like to thank Brit- rhagic shock. J Trauma. 2011;71(6):1869–1872.
tany Lassiter, Lorie Gower, and Diana Sheldon for their assis- 8. Morrison JJ, Galgon RE, Jansen JO, Cannon JW, Rasmussen TE, Elia-
son JL. A systematic review of the use of resuscitative endovascular
tance with study coordination. balloon occlusion of the aorta in the management of hemorrhagic
shock. J Trauma Acute Care Surg. 2016;80(2):324–334.
Disclosures 9. Brenner M, Bulger EM, Perina DG, et al. Joint statement from the
The authors have no conflicts of interest to disclose. American College of Surgeons Committee on Trauma (ACS COT)
and the American College of Emergency Physicians (ACEP) regarding
the clinical use of resuscitative endovascular balloon occlusion of the
Meetings aorta (REBOA). Trauma Surg Acute Care Open. 2018;3(1):e000154.
The research and data were presented at the 2021 American 10. Brenner ML, Moore LJ, DuBose JJ, et al. A clinical series of resuscita-
Academy of Emergency Medicine Resident Research Compe- tive endovascular balloon occlusion of the aorta for hemorrhage con-
trol and resuscitation. J Trauma Acute Care Surg. 2013;75(3):506–511.
tition, June 20–24, 2021, St. Louis, MO. 11. Moore LJ, Brenner M, Kozar RA, et al. Implementation of resuscita-
tive endovascular balloon occlusion of the aorta as an alternative to
Sources of Funding resuscitative thoracotomy for noncompressible truncal hemorrhage. J
Trauma Acute Care Surg. 2015;79(4):523–530.
This work was funded by CIP1 Funds from the Navy Surgeon 12. Cannon J, Morrison J, Lauer C, et al. Resuscitative endovascular
General Grant and RDT&E 6.6 funding in support of Clinical balloon occlusion of the aorta (REBOA) for hemorrhagic shock. Mil
Infrastructure, Naval Medical Center Portsmouth, VA. Med. 2018;183(suppl_2):55–59.
13. Brenner M, Hoehn M, Pasley J, Dubose J, Stein D, Scalea T. Basic
endovascular skills for trauma course: bridging the gap between endo-
Disclaimer vascular techniques and the acute care surgeon. J Trauma Acute Care
The views expressed in this article reflect the results of re- Surg. 2014;77(2):286–291.
search conducted by the authors and do not necessarily reflect 14. Linnebur M, Inaba K, Haltmeier T, et al. Emergent non-image-guided
the official policy or position of the Department of the Navy, resuscitative endovascular balloon occlusion of the aorta (REBOA)
the Department of Defense, or the United States Government. catheter placement: a cadaver-based study. J Trauma Acute Care Surg.
2016;81(3):453–457.
15. Davidson AJ, Russo RM, Reva VA, et al. The pitfalls of resuscitative
Copyright Statement endovascular balloon occlusion of the aorta: risk factors and mitiga-
TRL, CDT, EFS, SMS, WDB, and AJM are military service tion strategies. J Trauma Acute Care Surg. 2018;84(1):192–202.
members. This work was prepared as part of their official du- 16. Glaser J, Stigall K, Cannon J, et al. Joint Trauma System Clinical Prac-
tice Guideline (JTS CPG): Resuscitative Endovascular Balloon Oc-
ties. Title 17 U.S.C. §105 provides that “Copyright protection clusion of the Aorta (REBOA) for Hemorrhagic Shock (CPG ID:38).
under this title is not available for any work of the United Publication date: 31 March 2020.
States Government.” Title 17 U.S.C. §101 defines a United 17. Bogert JN, Patel BM, Johnson DJ. Ultrasound optimization for resus-
States Government work as a work prepared by a military ser- citative endovascular balloon occlusion of the aorta. J Trauma Acute
Care Surg. 2017;82(1):204–207.
vice member or employee of the United States Government as 18. Guliani S, Amendola M, Strife B, et al. Central aortic wire confirmation
part of that person’s official duties. for emergent endovascular procedures: as fast as surgeon- performed
ultrasound. J Trauma Acute Care Surg. 2015;79(4):549–554.
Author Contributions 19. Chaudery M, Clark J, Morrison JJ, Wilson MH, Bew D, Darzi A. Can
The literature search was conducted by PF, WDB, and AJM. contrast-enhanced ultrasonography improve zone III REBOA place-
ment for prehospital care? J Trauma Acute Care Surg. 2016;80(1):
The study was designed by SMS, PF, WDB, AJM, and EEF. 89–94.
Funding was undertaken by SMS, WDB, and EEF. Model de- 20. Ogura T, Lefor AK, Nakamura M, Fujizuka K, Shiroto K, Nakano M.
velopment and training were undertaken by TRL, CDT, and Ultrasound-guided resuscitative endovascular balloon occlusion of the
aorta in the resuscitation area. J Emerg Med. 2017;52(5):715–722.
EFS. Data collection was performed by TRL, CDT, EFS, MLB, 21. Redman TT, Ross EM. A novel expeditionary perfused cadaver model
MB, and PF. Data analysis was performed by EEF. Data inter- for trauma training in the out-of-hospital setting. J Emerg Med. 2018;
pretation was performed by TRL, CDT, SMS, and EEF. The 55(3):383–389.
paper was written by TRL, CDT, and EEF. Critical revision 22. Bujang MA, Adnan TH. Requirements for minimum sample size for
was undertaken by TRL, CDT, EFS, WDB, AJM, and EEF. All sensitivity and specificity analysis. J Clin Diagn Res. 2016;10(10):
YE01–YE06.
authors read and approved the final manuscript. 23. Hallgren KA. Computing inter-rater reliability for observational data:
An overview and tutorial. Tutor Quant Methods Psychol. 2012;8(1):
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