Balloon Technique Study
An experimental arterial balloon procedure successfully increased blood pressure and circulation to the heart and brain in patients undergoing prolonged out-of-hospital cardiac arrest, according to new research reported by Medical Xpress.
Out-of-hospital cardiac arrest carries a low survival rate of roughly 1 in 10. Investigators presented these preliminary late-breaking findings at the American Heart Association’s Resuscitation Science Symposium in Chicago.
East Anglian Air Ambulance
The procedures took place between June 2024 and June 2026 across the eastern region of England, United Kingdom.
Participants included 39 adults with an average age of 59 years, comprising 35 men and 4 women. These individuals experienced medical cardiac arrests that failed to respond to standard advanced cardiac life support.
“After cardiac arrest, people whose hearts cannot be restarted despite prolonged, high-quality resuscitation efforts, including CPR, breaths, use of an AED, medications and other techniques to restore the heartbeat, currently have very few treatment options and an extremely low chance of survival,” said James Price, lead author of the study and consultant emergency physician at Cambridge University Hospitals NHS Foundation Trust.
Aortic Balloon Occlusion
Researchers utilized resuscitative endovascular balloon occlusion of the aorta, commonly known as REBOA. Clinicians pass a small balloon through an artery in the groin and inflate it inside the aorta to control internal bleeding.
For this feasibility study, teams targeted Zone 1 of the aorta, located above the diaphragm. Laboratory tests previously suggested that upper aortic occlusion might redirect blood flow toward the brain and increase pressure in the vessels supplying the heart muscle.
The air ambulance physicians successfully deployed the balloon in 33 of 36 attempts. The procedure took about seven minutes, with a median time of 51 minutes from actual cardiac arrest to balloon inflation.
| Physiological Measure | Baseline Average | Post-REBOA Measurement | Observed Change |
|---|---|---|---|
| Aortic Diastolic Blood Pressure | 26 mm Hg | 42 mm Hg (reaching 58 mm Hg max) | 59% increase (up to 118% max) |
| Systolic Blood Pressure | 76 mm Hg | 91 mm Hg | 20% increase |
| Exhaled Carbon Dioxide | Baseline level | Measured value | 50% increase in average amount |
Resuscitation Response Data
The intervention produced immediate physiological changes across all 33 patients with confirmed occlusion. Aortic diastolic blood pressure rose from 26 to 42 mm Hg, representing an immediate 59% increase. Systolic blood pressure increased by 20%, moving from an average of 76 to 91 mm Hg.
Exhaled carbon dioxide levels increased by 50%. Medical teams monitor exhaled carbon dioxide as an indicator of blood flow through the lungs and circulation effectiveness during resuscitation.
Researchers reported no serious adverse effects related to the procedures. Price noted that the physiological response remained substantial despite the late stage of deployment, occurring an average of 51 minutes after cardiac arrest.
Survival Outcomes
Overall, among the 33 patients who received successful aortic occlusion, eight regained a sustained return of spontaneous circulation. Two patients survived and left the hospital with good neurological outcomes.
Within this group, four patients regained a pulse, and two survived to hospital discharge with good brain function.
Price emphasized that the feasibility trial was not designed to prove survival benefits.
Frequently Asked Questions
What is REBOA and how does it work during cardiac arrest?
REBOA stands for resuscitative endovascular balloon occlusion of the aorta. Clinicians insert a small balloon via the groin artery and inflate it in the upper aorta to temporarily block blood flow to the lower body, thereby redirecting oxygenated blood toward the brain and heart.
How long did the balloon procedure take in the study?
The deployment took about seven minutes from start to finish. The median time from the initial cardiac arrest to actual balloon inflation was 51 minutes.
Did the study prove that REBOA increases long-term survival?
While two patients were discharged with good neurological function, larger trials are needed to establish definitive survival benefits.
Who conducted the research?
The study was conducted by physicians from the East Anglian Air Ambulance in England between June 2024 and June 2026. Lead author James Price serves as a consultant emergency physician at Cambridge University Hospitals NHS Foundation Trust.
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