Accession Number:

ADA616881

Title:

Aortic Balloon Occlusion is Effective in Controlling Pelvic Hemorrhage

Descriptive Note:

Journal article

Corporate Author:

ARMY INST OF SURGICAL RESEARCH FORT SAM HOUSTON TX

Personal Author(s):

• Morrison, Jonathan J.
• Percival, Thomas J.
• Markov, Nickolay P.
• Villamaria, Carole
• Scott, Daniel J.
• Saches, Kaylyn A.
• Spencer, Jerry R.
• E., Todd

Report Date:

2012-05-08

Pagination or Media Count:

8.0

Abstract:

Background The objective of this study was to evaluate the efficacy of resuscitative endovascular aortic balloon occlusion REBOA of the distal aorta in a porcine model of pelvic hemorrhage. Methods Swine were entered into three phases of study injury iliac artery, hemorrhage 45 s, and intervention 180 min. Three groups were studied no intervention NI, n 7, a kaolin-impregnated gauze Combat Gauze CG, n 7, or REBOA n 7. The protocol was repeated with a dilutional coagulopathy CG-C, n 7, and REBOA-C, n 7. Measures of physiology, rates of hemorrhage, and mortality were recorded. Results Rate of hemorrhage was greatest in the NI group, followed by the REBOA and CG groups 822 - 415 mLmin versus 11 - 13 and 0.2 - 0.4 mLmin respectively P 0.001. MAP following intervention at 15 min was the same in the CG and REBOA groups and higher than in the NI group 70 - 4 and 70 - 11 mm Hg versus 5 - 13 mm Hg respectively P 0.001. There was 100 mortality in the NI group, with no deaths in the CG or REBOA group. In the setting of coagulopathy, the rate of bleeding was higher in the CG-C versus the REBOA-C group 229 - 295 mLmin versus 20 - 7 mLmin, P 0.085. MAP following intervention 15 min was higher in the REBOA-C than the CG-C group 71 - 12 mm Hg versus 28 - 31 mm Hg P 0.005. There were 5 deaths 71.4 in the CG-C group, but none in the REBOA-C group P 0.010. Conclusion Balloon occlusion of the aorta is an effective method to control pelvic arterial hemorrhage. This technique should be further developed as an adjunct to manage noncompressible pelvic hemorrhage.

Descriptors:

• *AORTA
• *HEMORRHAGE
• *OBSTRUCTION(PHYSIOLOGY)
• BALLOONS
• HEMORRHAGIC SHOCK
• MORTALITY RATE
• PELVIS
• SWINE
• WOUNDS AND INJURIES

Subject Categories:

• Anatomy and Physiology
• Medicine and Medical Research

Distribution Statement:

APPROVED FOR PUBLIC RELEASE