Novel interventions for non-compressible torso hemorrhage: Secondary considerations in consequences of aortic occlusion

Non-compressible torso hemorrhage in trauma remains a leading cause of death in austere environments. Advance-ments for treatment include resuscitative endovascular balloon occlusion of the aorta (REBOA), selective aortic arch perfusion (SAAP), and external compression approaches (junctional tourniquets and abdominal aortic tourniquets), which have provided several promising avenues. However, the application of these devices carries the risk of distal ischemia and the consequences associated with reperfusion injury. This review aims to look at these novel interventions and the physiologic burden associated with them. Following a review of these new advents, we will evaluate the possible solutions to reverse the physiologic penalties.