Assessing the Hemodynamic Effects of Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) in Traumatic Cardiac Arrest When Closed Chest Compressions are Augmented by Directing the Area of Maximal Compression Over the Left Ventricle in a Swine Model (sus scrofa)
Abstract
Evidence shows that LVCC during TCPA improve hemodynamics and ROSC compared to standard CC. REBOA improves hemo-dynamics and controls hemorrhage during TCPA. Hypothesis: REBOA and LVCC improve hemodynamics and ROSC in swine. TTE used to mark the AR and LV on animals (n=52) which were randomized to CC in one of two areas. Half the animals in each group had REBOA 30% hemorrhage and VF induced to simulate TCA. After 10 min of VF, BLS initiated for 10 mins, ACLS w/blood transfusion for 10 more mins. REBOA balloon inflated at BLS min6. ROSC increased in standard CC w/REBOA(33%) compared to standard CC w/out REBOA(0.0%)(p=0.04). In standard CC animals, aortic SBP, right atrial SBP and ETCO2 increased during BLS (p<0.005) w/REBOA. ETCO2 increased during BLS in LVCC w/REBOA compared to LVCC w/out REBOA(p=0.0001). ROSC and other hemodynamics no significant difference. No difference in ROSC or hemodynamics between the LVCC and standard CC w/REBOA. In our model of TCPA, ROSC and hemodynamics improved in standard CC arm. No additional benefit with REBOA in LVCC.
Document Details
- Document Type
- Technical Report
- Publication Date
- Sep 15, 2016
- Accession Number
- AD1017235
Entities
People
- Jeffrey Morgan
- Kenton Anderson
- Maria G. Castaneda
- Susan M. Boudreau
- Vikhyat S Bebarta
Organizations
- 59th Medical Wing