Society of University SurgeonsEndovascular balloon occlusion of the aorta is superior to resuscitative thoracotomy with aortic clamping in a porcine model of hemorrhagic shock
Section snippets
Study approval and overview
Institutional Animal Care and Use Committee (IACUC) approval was obtained from our institution before the study was undertaken. Procedures were performed at an accredited facility (Lackland Air Force Base, San Antonio, TX) in compliance with IACUC policies and under the supervision of a licensed veterinary staff. Female Yorkshire–Landrace crossbred swine (John Albert, Cibolo, TX) (age range, 5–6 months; weight range, 70–95 kg) were housed at the facility 7 days before the protocol to allow for
Outcomes and perfusion measurements
There was no difference in mortality among the CO, BO, or NO groups (0%, 0%, and 17%, respectively; P = not significant [NS]). The single fatality in the NO group occurred during the resuscitation phase with no obvious cause of death at necropsy. Total shed blood volume was greatest in the NO group by protocol design, given the increased time of ongoing hemorrhage in this group (CO: 1,998 ± 307 mL; BO: 2,087 ± 105; NO: 2,353 ± 194 mL; P = .03).
All vascular shunts remained patent after placement
Discussion
This study demonstrates the feasibility of resuscitative aortic BO in a large animal model of end-stage hemorrhagic shock. Endovascular BO resulted in increases in central aortic pressure, carotid flow, and partial oxygenation pressure of the brain that were equal to those increases associated with open clamping of the aorta. In contrast to resuscitative thoracotomy with aortic clamping, findings from this study demonstrate that endovascular BO results in less acidosis and lower resuscitative
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The results of this study and opinions expressed in the manuscript are the views of the authors and are not to be construed as official statements by or as a reflection of the views of the U.S. Department of the Air Force, the U.S. Department of the Army, or the U.S. Department of Defense.