REBOA management guided by a novel handheld pressure transducer.

BACKGROUND Management of noncompressible truncal hemorrhage utilizing REBOA requires arterial pressure monitoring that can be logistically challenging in austere or emergency settings. Novel pressure transducer devices such as the Centurion COMPASS® device (CD) offer an alternative to traditional monitoring systems. We sought to assess the feasibility of maintaining permissive hypotension during intermittent REBOA in a porcine model guided by CD monitoring. METHODS Eight Yorkshire swine underwent 20% hemorrhage with an uncontrolled iliofemoral vascular injury. Time-based intermittent zone 1 REBOA was performed with volume-based resuscitation to maintain permissive hypotension. Proximal MAPs from a carotid arterial line (AL) were obtained and compared to CD readings from the proximal REBOA port. The operator was blinded to AL MAP, and the REBOA was managed with exclusively the CD. RESULTS Mean survival time was 100 (range 41-120) minutes from injury. AL and CD measurements were closely correlated (r = .94, p < .001). Bland-Altman analysis for comparison of clinical measurements demonstrated a mean difference of 6 mmHg (95% CI -22 to 34 mmHg) for all MAPs, with a mean difference of 3 mmHg (95% CI -6 to 12 mmHg) in a clinically relevant MAP <65 subset. CONCLUSIONS The CD represents a miniaturized and portable arterial pressure monitor that provides an accurate alternative to logistically burdensome AL monitoring to guide REBOA use. The device is highly accurate even at hypotensive pressures and can be used to guide intermittent REBOA strategies. LEVEL OF EVIDENCE V, Animal Research.