Determining the Cardiovascular Effect of Partial versus Complete REBOA in a Porcine (Sus scrofa) Model of Hemorrhagic Shock.
Technical Report,03 Jan 2017,02 Mar 2018
DAVID GRANT USAF MEDICAL CENTER TRAVIS AFB CA TRAVIS AFB United States
Pagination or Media Count:
Objectives The objective of this study was to characterize, quantify, and compare the effects of REBOA and Endovascular Variable Aortic Control EVAC on cardiac function. Methods Eighteen swine underwent hemorrhage of 25 blood volume, followed by 45 minutes of REBOA, EVAC, or no intervention control. Balloon volume in the EVAC arm was titrated to maintain aortic flow AF 300 mLmin. Animals were resuscitated with shed blood, intra-aortic balloons were deflated, and five hours of critical care ensued prior to euthanasia. Cardiac function was measured continuously with a Scisense Pressure-Volume Catheter Transonic Systems Inc. in the left ventricle. Results There were no differences in cardiac output at the start of experiment REBOA 5.33.6 Lmin versus EVAC 4.11.4 Lmin, p0.39 or at the end of the 30 minute bleed period REBOA 5.71.9 Lmin versus EVAC 5.91.9 Lmin, p0.81. During the intervention, there were no differences in average cardiac output REBOA 11.54.5 Lmin versus EVAC 7.52.8 Lmin, p0.09 or maximal cardiac output REBOA 14.55.3 Lmin versus EVAC 9.33.1 Lmin, p0.08. During critical care, REBOA animals had higher cardiac output 10.25.3 Lmin compared to EVAC animals 6.22.9 Lmin, p0.02.Conclusion This study demonstrates that although EVAC does not change the cardiac output required during the intervention, EVAC does allow for lower cardiac output during critical care when compared to complete REBOA.
- Medicine and Medical Research
- Anatomy and Physiology