Original CommunicationPhysiologic tolerance of descending thoracic aortic balloon occlusion in a swine model of hemorrhagic shock
Section snippets
Study approval and overview
Institutional Animal Care and Use Committee approval was obtained in accordance with all applicable laws, regulations, and policies. Procedures were performed at an accredited facility (Lackland Air Force Base, San Antonio, TX) in compliance with the committee’s policies and under the supervision of a licensed veterinary staff. Female Yorkshire-Landrace crossbred swine (John Albert, Cibolo, TX) (age range, 5 to 6 months; weight range 70 to 90 kg) were housed at the facility for 7 days before
Baseline characteristics and mortality
The baseline characteristics of the 4 study groups (n = 6/group), are shown in Table I. Time 0 occurred at the start of the hemorrhage phase and served as the reference point for all reported time points and values. There was no significant difference in weight or volume of hemorrhage (per kg) used to induce shock. Measures of perfusion and organ function were also similar among the groups. There were 2 deaths: 1 animal died in the 30-Shock group during the hemorrhage phase and another animal
Discussion
This study characterized the physiologic sequelae of zone 1 REBOA in the setting of class IV shock compared to shock alone for either 30 or 90 min. After the controlled hemorrhage, both REBOA groups had greater central aortic pressure and cerebral tissue oxygen levels than did shock-alone animals. These effects were achieved at the expense of a greater increase in serum lactate concentration after balloon deflation, as a consequence of visceral and lower extremity reperfusion. Lactate
References (19)
- et al.
Hemodynamic effects of aortic occlusion during hemorrhagic shock
Ann Emerg Med
(1982) - et al.
Societal costs of inappropriate emergency department thoracotomy
J Am Coll Surg
(2012) - et al.
Endovascular balloon occlusion of the aorta is superior to resuscitative thoracotomy with aortic clamping in a porcine model of hemorrhagic shock
Surgery
(2011) - et al.
Died of wounds on the battlefield: causation and implications for improving combat casualty care
J Trauma
(2011) - et al.
Causes of death in U.S. Special Operations Forces in the global war on terrorism: 2001-2004
Ann Surg
(2007) - et al.
Injury severity and causes of death from Operation Iraqi Freedom and Operation Enduring Freedom: 2003-2004 versus 2006
J Trauma
(2008) - et al.
The epidemiology and modern management of traumatic hemorrhage: US and international perspectives
Crit Care
(2005) - et al.
Analysis of preventable trauma deaths and opportunities for trauma care improvement in Utah
J Trauma
(2011) - et al.
Defining the limits of resuscitative emergency department
J Trauma
(2011)
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Supported by the US Air Force, Clinical Research Division, Lackland AF Base, San Antonio, TX.