A Comparison of Zone 3 Resuscitative Endovascular Balloon Occlusion of the Aorta to the Abdominal Aortic and Junctional Tourniquet AAJT in a Lethal Pelvic Injury Swine Model
Technical Report,01 Oct 2015,31 Jul 2017
59th Medical Wing Science and Technology JBSA United States
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Traumatic injuries to the pelvis and high junctional injuries are difficult to treat in the field however, Resuscitative Endovascular Balloon Occlusion of the Aorta REBOA and the Abdominal Aortic and Junctional Tourniquet AAJT constitute two promising treatment modalities. The aim of this study is to use a large animal model of pelvic hemorrhage to compare the survival, hemostatic, hemodynamic, and metabolic profile of both techniques. Yorkshire swine N10, 70-90 kg underwent uncontrolled hemorrhage of the femoral artery by arteriotomy. Animals were randomly allocated to either REBOA or AAJT. After one hour, the injured femoral artery was ligated to simulate definitive hemostasis followed by a second Hextend bolus and device removal. Animals were observed for two more hours. Physiological data was collected throughout the experiments and compared between groups. No differences were found between groups with regards to pretreatment blood loss or blood chemistries. Both techniques effectively controlled hemorrhage in all animals, with no difference in mortality. During the 60-minute treatment phase, the AAJT group had a higher lactate level and MAP compared to the REBOA group repeated measures ANOVA p0.05. Despite mechanistic differences between REBOA and the AAJT, both techniques achieve a similar hemostatic, hemodynamic and metabolic profile.
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