Partial Resuscitative Endovascular Balloon Occlusion of the Aorta (P-REBOA) in a Pig Model (Sus scrofa)
60 MDG CIF Travis AFB United States
Pagination or Media Count:
Background Partial REBOA P-REBOA may permit longer periods of occlusion by allowing some degree of distal perfusion. However the ability of this procedure to limit exsanguination is unclear. We evaluated the impact of P-REBOA on immediate survival in a highly lethal swine liver injury model. Methods Fifteen Yorkshire-cross swine were anesthetized, instrumented, splenectomized, and subjected to 30 liver amputation. Coagulopathy was created through hemodilution. Randomized swine received no intervention control, P-REBOA, or complete REBOA C-REBOA. Central mean arterial pressure cMAP, carotid blood flow, and blood loss were recorded. Balloons remained inflated in the P-REBOA and C-REBOA groups for 90m followed by graded deflation. The study ended at 180m from onset of hemorrhage or death of the animal. Survival analysis was performed. Results Survival times in the control, P-REBOA, and C-REBOA groups were, 2521, 8640, and 16320m, respectively p0.001. There was no difference in blood loss among the groups. P-REBOA maintained near-baseline carotid blood flow and cMAP, while C-REBOA generated extreme cMAP and prolonged supraphysiologic carotid blood flow. Both experimental groups experienced profound decreases in cMAP following deflation. Conclusions With severe ongoing hemorrhage, P-REBOA increased survival time while maintaining cMAP and carotid flow at physiologic levels.
- Medicine and Medical Research