Technique Refinement and Validation of Variable Aortic Occlusion via Extracorporeal Flow Circuit in a Pig Model (Sus scrofa) of Uncontrolled Hemorrhage with Subsequent Resuscitation and Critical Care
60 MDG CIF Travis AFB United States
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Objectives The purpose of the study was to develop and refine the technique of permissive regional hypoperfusion in a large animal model to serve as a foundation for further investigation. This novel therapy is targeted towards non-compressible truncal hemorrhage, a major source of death on the battlefield. Methods The study utilized a novel extracorporeal flow circuit capable of delivering tightly regulated distal aortic blood flow. Animals underwent a uniformly lethal liver injury, were then subjected to a brief period of complete aortic occlusion followed by a prolonged period of distal regional hypoperfusion. Subsequently, the liver injury was controlled and the animals were resuscitated with blood during a critical care phase. Results This resuscitation strategy prevented early demise of the study animals and minimized the ischemic insult to distal vascular beds, thus preserving organ viability as evidenced by early return of urine output and clearing of lactate levels in most animals. Conclusion This study serves as foundational evidence for the viability of this resuscitative paradigm. In otherwise fatal injuries, these animals survived with near normal physiologic parameters at the end of the study period. Further studies have been conducted under other IACUC approved protocols, confirming efficacy of this strategy.
- Medicine and Medical Research