Examination of hemodynamics in patients in hemorrhagic shock undergoing Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA)

•Significant hemodynamic changes occurred in patients with Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA).•The effects of Zone 1 REBOA on blood pressure and heart rate appear different than Zone 3.•Significant hemodynamic variability with episodes of hypertension and hypotension occurred in a large proportion of cases during REBOA.•There may be a precipitous decrease in blood pressure that should be anticipated following balloon deflation of the REBOA catheter. The objective of this study was to investigate the hemodynamic effects of aortic occlusion (AO) during Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) using a sophisticated continuous vital sign (CVS) monitoring tool. Patients admitted between February 2013 and May 2017 at a tertiary center that received REBOA were included. Patients in cardiac arrest before or at the time of REBOA were excluded. Time of AO was documented by time-stamped videography and correlated with CVS data. 28 patients were included, mean (standard deviation) ISS was 38 (11). 18 received Zone 1 (distal thoracic aorta) and 10 received Zone 3 (distal abdominal aorta) AO. Among Zone 1 patients the pre-AO systolic blood pressure (SBP) nadir was 64 (19) mmHg, which increased to a mean of 124 (29) mmHg within 5 min after AO (p