The Effect of Infrarenal Aortic Balloon Occlusion on Weaning from Supraceliac Aortic Balloon Occlusion in a Porcine Model (Sus scrofa) of Hemorrhagic Shock
[Technical Report, Final Report]
DAVID GRANT USAF MEDICAL CENTER TRAVIS AFB CA
Pagination or Media Count:
Objectives We sought to determine whether stepwise reperfusion after supraceliac Zone-1 REBOA by transitioning to infrarenal Zone-3 occlusion would mitigate the physiologic consequences of balloon deflation and decrease hemodynamic instability. Methods Twelve swine underwent controlled hemorrhage of 25 blood volume, 45 minutes of Zone-1 REBOA, then resuscitation with shed blood. Critical care began with deflation of the Zone-1 balloon in all animals, and continued for six hours. Half of the animals were randomly assigned to Zone-3 REBOA for an additional 45 minutes following Zone-1 balloon deflation. Results There were no differences in physiology at baseline, during the initial 30 minutes of hypotension, or during the 45 minutes of Zone-1 occlusion. After Zone-1 balloon deflation, there was no difference in proximal mean arterial pressure pMAP with or without Zone-3 occlusion, or percentage of critical care time spent within target pMAP range 65-75 mmHg. There were no significant differences in peak lactate concentration or resuscitation requirements. Conclusion In an animal model of hemorrhagic shock and Zone-1 REBOA, subsequent Zone-3 aortic occlusion did not add significant ischemic burden, but it also did not provide significant hemodynamic support. Continued investigation is necessary to determine optimal resuscitative support strategies during reperfusion following Zone-1 REBOA.
- Medicine and Medical Research