Potential Use of Selective Aortic Arch Perfusion (SAAP) to Induce Profound Hypothermia for Emergency Preservation and Resuscitation (EPR)

The majority of potentially survivable injuries on the battlefield are associated with hemorrhage. Emergency preservation and resuscitation (EPR) is a method of extending the window of organ viability following severe hemorrhage to allow for surgical interventions and repair. Highly invasive methodologies are currently used for induction of EPR. The purpose of this study was to determine if EPR by profound hypothermia could effectively be induced by the introduction of cold fluids through the Selective Aortic Arch Perfusion (SAAP) catheter. The SAAP catheter is a balloon tipped catheter with a large lumen designed to deliver high volumes of fluids directly to the aortic arch while facilitating hemostasis similar to resuscitative endovascular balloon occlusion of the AORTA (REBOA). A swine model of hemorrhage induced cardiac arrest was used. Results show that the SAAP catheter was able to effectively induce EPR, defined by brain temperature, in only one subject out of the ten tested. These results indicate that induction of EPR through the SAAP catheter is possible, but unlikely.