pREBOA Abroad: Leveraging Partial Aortic Occlusion for Stabilization and Transport in Ukraine

TL;DR

This paper discusses using partial aortic occlusion to stabilize injured patients in Ukraine's war zone, enabling safer transport to definitive care.

Contribution

Demonstrates the use of pREBOA-PRO™ for temporary hemorrhage control in austere environments, extending stabilization time during transport.

Findings

Partial aortic occlusion with pREBOA-PRO™ increased central perfusion pressure and provided temporary hemorrhage control.

The device allowed stabilization of a critically injured patient for transport in a resource-limited setting.

Use of pREBOA-PRO™ mitigated distal ischemic consequences during prolonged occlusion.

Abstract

The war in Ukraine highlights the challenges in providing combat casualty care when both nations are near-peer adversaries. Providing timely definitive hemorrhage control within one hour of injury, as the US military and its allies have grown accustomed, is unrealistic. Stabilization points (SP) in Ukraine are forced to provide prolonged field care to exsanguinating patients with little resources while waiting extended periods of time for patient transport. pREBOA-PRO™ (Prytime Medical, Boerne, TX)has been suggested as a bridge to this problem as it can provide temporary hemorrhage control, stabilize the patient, and limit distal ischemic consequences when used for partial aortic occlusion. We discuss a patient who suffered a traumatic arm amputation and intra-abdominal injuries managed with pREBOA-PRO™. This partial aortic occlusion provided an increase in central perfusion pressure, temporary hemorrhage control, and time for patient transport to definitive hemorrhage control. This serves as proof of concept that pREBOA-PRO™ and partial aortic occlusion can stabilize a patient, provide longer safe occlusion times, and aid in transport in austere environments while mitigating distal ischemic consequences.

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