Partial Resuscitative Endovascular Balloon Occlusion of the Aorta (P-REBOA) in a Pig Model (Sus scrofa) with ongoing Resuscitation
60 MDG CIF Travis AFB United States
Pagination or Media Count:
INTRODUCTION Resuscitative Endovascular Balloon Occlusion of the Aorta REBOA is limited by the short duration of tolerable ischemia and resulting reperfusion injury. P-REBOA relies on regional permissive hypo-perfusion to limit exsanguination while providing limited perfusion to distal tissue beds. METHODS An automated extracorporeal circuit was developed to perform P-REBOA. The circuit was used in a large animal model of highly lethal uncontrolled hemorrhage. RESULTS Nine animals were used for animal development, with 7 animals surviving the initial surgical preparatory phase. Severe injury was accomplished via liver laceration resulting in profound hypotension prior to complete aortic occlusion. After 20 minutes of complete occlusion, regulated flow provided perfusion to capillary beds. Following 70 minutes of partial aortic occlusion, damage control surgery and whole blood resuscitation was performed and all animals were survived to 360 minutes. Animals that tolerated distal flow had decreased levels of lactate, preserved renal function, and were weaned from aortic occlusion more rapidly. CONCLUSIONS P-REBOA is capable of limiting exsanguination while providing blood flow to distal organs prior to definitive hemorrhage control. There is no current endovascular device that possesses the ability to achieve P-REBOA.
- Anatomy and Physiology
- Medicine and Medical Research