Physicians in England used a minimally invasive balloon technique in a small study to improve blood flow to the heart and brain during out-of-hospital cardiac arrest, newsroom.heart.org reported.
The study, presented at this week’s American Heart Association’s Resuscitation Science Symposium 2026, explored using Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) in patients who had not responded to standard advanced cardiac life support. The procedure, which inflates a balloon in the body’s largest artery, is already used in trauma centers to control bleeding and is now being studied for cardiac arrest.
How the REBOA Technique Redirects Blood Flow During CPR
During cardiac arrest, standard CPR often fails to restore adequate blood flow to vital organs. The REBOA procedure aims to solve this by physically redirecting blood flow. A small balloon is inserted through an artery in the groin and guided into the upper part of the aorta, or Zone 1. Once inflated, it temporarily blocks blood flow to the lower body, forcing more oxygenated blood to the heart and brain.
The technique’s mechanism of action is a strategic redistribution of aortic pressure. In the context of cardiac arrest, this action is critical. The lower blood pressure number, or diastolic pressure, is particularly important for restarting the heart. The study found this measure increased by 59%, while the upper number, systolic pressure, which is key for brain blood flow, rose by 20%. End-tidal carbon dioxide, a marker of circulation effectiveness, increased by 50%.
In Plain English: The Clinical Takeaway
- REBOA is a minimally invasive procedure where a small balloon is inflated in the main artery to send more blood to the heart and brain during a cardiac arrest.
- Early results show it can boost blood pressure levels during CPR, which is crucial for restarting the heart and protecting the brain.
- While promising, this is a preliminary study and is not yet proof that REBOA saves lives; more research is needed.
Key Findings from the Feasibility Study
The 2-year feasibility study, conducted by the East Anglian Air Ambulance in England, involved 39 adults experiencing out-of-hospital cardiac arrest who had not responded to standard ACLS. The research team successfully deployed the REBOA balloon in 33 of the 36 patients, with the procedure taking about 7 minutes to complete from start to finish. The median time from the cardiac arrest to balloon inflation was 51 minutes.
The physiological improvements were substantial. Aortic diastolic blood pressure—the lower number in a blood pressure reading—rose from 26 to 42 mm Hg, reaching a maximum of 58 mm Hg. Systolic pressure increased from 76 to 91 mm Hg. End-tidal carbon dioxide, a key indicator of blood flow to the lungs, increased by an average of 50%. Researchers noted these changes suggest the balloon successfully redirected blood as intended.
Although the study was not designed to measure survival outcomes, some results were encouraging. In the 33 patients with confirmed balloon occlusion, eight regained a sustained return of spontaneous circulation (ROSC), and two survived to be discharged from the hospital with a good neurological outcome. In a small subgroup of patients with witnessed ventricular fibrillation who were treated earlier (at a median of 44 minutes), four out of five achieved ROSC, and two survived with a good outcome.
| Clinical Measure | Change During REBOA |
|---|---|
| Aortic Diastolic Blood Pressure (mm Hg) | Increased 59% (from 26 to 42) |
| Systolic Blood Pressure (mm Hg) | Increased 20% (from 76 to 91) |
| End-Tidal Carbon Dioxide | Increased 50% |
From Trauma Bay to Cardiac Arrest Resuscitation
REBOA is used in trauma centers to treat life-threatening internal bleeding by temporarily blocking blood flow to areas of major bleeding below the balloon while maintaining blood flow to vital organs above it. The new research represents an application of this technique for cardiac arrest.
James Price, lead author of the study, highlighted the significance of adapting this tool. “This study is an important first step, but it is not yet proof that REBOA saves lives,” he said. “A key part of our additional work will be to understand which patients are more likely to benefit from this advanced technique and at what point in their resuscitation care.”
Regulatory and Systemic Challenges for Broader Use
Currently, the technique is not routinely available in emergency medical services in either the United Kingdom or the United States. Its use is most often used in trauma centers and is being explored by prehospital professionals.
To make this a viable prehospital intervention, future strategies may involve expanding its use to specially trained non-physician responders, such as advanced paramedics.
Researchers Stress That Findings Are Preliminary
The study was conducted by the East Anglian Air Ambulance. The American Heart Association, which hosted the presentation, supports research, advocates for public health and provides resources to save and improve lives affected by cardiovascular disease and stroke. The Association has strict policies to prevent any donations from influencing its science content and policy positions.
Researchers stress that the findings are preliminary and require further investigation. The next steps involve larger, prospective studies with appropriate comparison groups to definitively assess whether REBOA improves survival and patient-centered outcomes. A key focus will be identifying the optimal patient population and the ideal timing for intervention.
Contraindications & When to Consult a Doctor
REBOA is a highly specialized emergency procedure used in specific, critical situations by trained medical professionals. It is not a treatment that patients or families can request. Anyone who experiences or witnesses a cardiac arrest should immediately call emergency services and begin standard CPR. This is not a substitute for established emergency protocols.
“This study is an important first step, but it is not yet proof that REBOA saves lives. A key part of our additional work will be to understand which patients are more likely to benefit from this advanced technique and at what point in their resuscitation care. These questions will need larger prospective studies with appropriate comparison groups and a focus on patient-centered outcomes rather than physiological measurements alone.” — James Price, lead author of the study.
While survival rates have remained low, this preliminary research offers a new avenue for investigation. The success of REBOA in improving physiological markers during resuscitation provides a scientific rationale for further study. If larger trials confirm its benefits, this technique could become a tool for emergency responders, offering hope for better survival and neurological recovery for patients who currently have very few treatment options.
References
- American Heart Association. (2026). Balloon technique may help improve circulation to heart and brain during cardiac arrest. newsroom.heart.org
- Price, J.M.B.B.S. et al. (2026). Feasibility of Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) in Out-of-Hospital Cardiac Arrest. Abstract presented at the Resuscitation Science Symposium 2026.
