Literature DB >> 32830262

Automated Partial Versus Complete Resuscitative Endovascular Balloon Occlusion of the Aorta for the Management of Hemorrhagic Shock in a Pig Model of Polytrauma: a Randomized Controlled Pilot Study.

Guillaume L Hoareau1,2, Carl A Beyer1,3, Connor A Caples1,3, Marguerite W Spruce1,3, J Kevin Grayson1, Lucas P Neff1,4, Timothy K Williams1,5, M Austin Johnson1,2.   

Abstract

INTRODUCTION: Endovascular variable aortic control (EVAC) is an automated partial resuscitative endovascular balloon occlusion of the aorta (REBOA) platform designed to mitigate the deleterious effects of complete REBOA. Long-term experiments are needed to assess potential benefits. The feasibility of a 24-hour experiment in a complex large animal trauma model remains unknown.
MATERIALS AND METHODS: Anesthetized swine were subjected to controlled hemorrhage, blunt thoracic trauma, and tibial fractures. Animals were then randomized (N = 3/group) to control (No balloon support), 90 minutes of complete supraceliac REBOA, or 10 minutes of supraceliac REBOA followed by 80 minutes of EVAC. One hundred ten minutes after injury, animals were resuscitated with shed blood, the REBOA catheter was removed. Automated critical care under general anesthesia was maintained for 24 hours.
RESULTS: Animals in the control and EVAC groups survived to the end of the experiment. Animals in the REBOA group survived for 120, 130, and 660 minutes, respectively. Animals in the EVAC group displayed similar mean arterial pressure and plasma lactate concentration as the control group by the end of the experiment. Histologic analysis suggested myocardial injury in the REBOA group when compared with controls.
CONCLUSIONS: This study demonstrates the feasibility of intermediate-term experiments in a complex swine model of polytrauma with 90 minutes of REBOA. EVAC may be associated with improved survival at 24 hours when compared with complete REBOA. EVAC resulted in normalized physiology after 24 hours, suggesting that prolonged partial occlusion is possible. Longer studies evaluating partial REBOA strategies are needed. © Association of Military Surgeons of the United States 2020. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

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Mesh：

Year:  2020        PMID： 32830262      PMCID： PMC7772517          DOI： 10.1093/milmed/usaa217

Source DB:  PubMed          Journal:  Mil Med        ISSN： 0026-4075            Impact factor:   1.437


  18 in total

1.  Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA): Zone I Balloon Occlusion Time Affects Spinal Cord Injury in the Nonhuman Primate Model.

Authors:  Jonathan L Eliason; Daniel D Myers; Abhijit Ghosh; Jonathan J Morrison; Angela R Mathues; Laura Durham; Veronica Dunivant; Andrew A Gonzalez; Todd E Rasmussen
Journal:  Ann Surg       Date:  2021-07-01       Impact factor: 12.969

Review 2.  The pitfalls of resuscitative endovascular balloon occlusion of the aorta: Risk factors and mitigation strategies.

Authors:  Anders J Davidson; Rachel M Russo; Viktor A Reva; Megan L Brenner; Laura J Moore; Chad Ball; Eileen Bulger; Charles J Fox; Joseph J DuBose; Ernest E Moore; Todd E Rasmussen
Journal:  J Trauma Acute Care Surg       Date:  2018-01       Impact factor: 3.313

3.  Resuscitative endovascular balloon occlusion of the aorta (REBOA) in a swine model of hemorrhagic shock and blunt thoracic injury.

Authors:  Carl A Beyer; Guillaume L Hoareau; Harris W Kashtan; Andrew M Wishy; Connor Caples; Marguerite Spruce; John K Grayson; Lucas P Neff; Timothy K Williams; Michael A Johnson
Journal:  Eur J Trauma Emerg Surg       Date:  2019-10-01       Impact factor: 3.693

4.  Authors' reply: Intermittent REBOA translational science articles.

Authors:  John Kuckelman; Matthew Eckert; Matthew J Martin
Journal:  J Trauma Acute Care Surg       Date:  2019-12       Impact factor: 3.313

5.  Letter to the editor: Response to letter from Dr. Martin et al: Not ready for prime time: Intermittent versus partial REBOA for prolonged hemorrhage control in a highly lethal porcine injury model.

Authors:  Michael Austin Johnson; Guillaume Hoareau; Timothy K Williams; Lucas P Neff
Journal:  J Trauma Acute Care Surg       Date:  2020-06       Impact factor: 3.313

6.  Resuscitative endovascular balloon occlusion of the aorta induced myocardial injury is mitigated by endovascular variable aortic control.

Authors:  Carl A Beyer; Guillaume L Hoareau; Emily M Tibbits; Anders J Davidson; Erik D DeSoucy; Meryl A Simon; John Kevin Grayson; Lucas P Neff; Timothy K Williams; Michael Austin Johnson
Journal:  J Trauma Acute Care Surg       Date:  2019-09       Impact factor: 3.313

7.  Endovascular Perfusion Augmentation for Critical Care: Partial Aortic Occlusion for Treatment of Severe Ischemia-Reperfusion Shock.

Authors:  M Austin Johnson; Emily M Tibbits; Guillaume L Hoareau; Meryl A Simon; Anders J Davidson; Erik S DeSoucy; E Robert Faulconer; J Kevin Grayson; Lucas P Neff; Timothy K Williams
Journal:  Shock       Date:  2019-05       Impact factor: 3.454

Review 8.  Principles for valid histopathologic scoring in research.

Authors:  K N Gibson-Corley; A K Olivier; D K Meyerholz
Journal:  Vet Pathol       Date:  2013-04-04       Impact factor: 2.221

9.  Effect of partial and complete aortic balloon occlusion on survival and shock in a swine model of uncontrolled splenic hemorrhage with delayed resuscitation.

Authors:  David S Kauvar; David W Schechtman; Sarah B Thomas; M Dale Prince; Rodolfo De Guzman; I Amy Polykratis; Bijan S Kheirabadi; Michael A Dubick
Journal:  J Trauma Acute Care Surg       Date:  2019-11       Impact factor: 3.313

10.  Extending resuscitative endovascular balloon occlusion of the aorta: Endovascular variable aortic control in a lethal model of hemorrhagic shock.

Authors:  Timothy Keith Williams; Lucas P Neff; Michael Austin Johnson; Sarah-Ashley Ferencz; Anders J Davidson; Rachel M Russo; Todd E Rasmussen
Journal:  J Trauma Acute Care Surg       Date:  2016-08       Impact factor: 3.313
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