REBOA can be performed in the emergency department not only for trauma patients but also for life-threatening vaginal bleeding

To the Editor,

We read the article “Implementation of resuscitative endovascular balloon occlusion of the aorta (REBOA) at the Korean Regional Trauma Center” by Park et al. ¹ with interest. The authors aimed to investigate the feasibility and effectiveness of REBOA based on their experience and shared their implementation process by trauma surgeons in Korea. They found that mean change of systolic blood pressure after REBOA was 41.3 ± 30.2 mm Hg. Finally, they concluded that REBOA is a useful adjunctive skill for trauma surgeons, and a brief training course can help in the implementation of the procedure.

REBOA is used as adjunctive management for a profound shock in some trauma centers. The goals of REBOA include the prevention or reversal of hemodynamic collapse by minimizing ongoing bleeding and restoration of adequate perfusion pressure to the heart, lungs, and brain. In a case report published by Özlüer et al., ² the authors performed intermittent REBOA in the emergency department to a vaginal bleeding patient with class 3 hemorrhagic shock. They reported that there was a serious increase in the systolic blood pressure of the patient after REBOA (from 93 to 125 mm Hg). They also reported that the patient completely recovered and was discharged on the seventh day of admission.

In conclusion, REBOA is a useful adjunctive skill either for trauma surgeons or for emergency physicians. However, this procedure can be a lifesaving treatment option not only for trauma patients but also for patients with non-traumatic life-threatening hemorrhage such as vaginal bleeding. In addition, the capacity of short training courses can be expanded to include emergency physicians.