Partial Resuscitative Endovascular Balloon Occlusion of the Aorta (P-REBOA) in a Pig Model (Sus scrofa)
Abstract
Background: Partial REBOA (P-REBOA) may permit longer periods of occlusion by allowing some degree of distal perfusion. However the ability of this procedure to limit exsanguination is unclear. We evaluated the impact of P-REBOA on immediate survival in a highly lethal swine liver injury model. Methods: Fifteen Yorkshire-cross swine were anesthetized, instrumented, splenectomized, and subjected to 30 liver amputation. Coagulopathy was created through hemodilution. Randomized swine received no intervention (control), P-REBOA, or complete REBOA (C-REBOA). Central mean arterial pressure (cMAP), carotid blood flow, and blood loss were recorded. Balloons remained inflated in the P-REBOA and C-REBOA groups for 90m followed by graded deflation. The study ended at 180m from onset of hemorrhage or death of the animal. Survival analysis was performed. Results: Survival times in the control, P-REBOA, and C-REBOA groups were, 2521, 8640, and 16320m, respectively (p<0.001). There was no difference in blood loss among the groups. P-REBOA maintained near-baseline carotid blood flow and cMAP, while C-REBOA generated extreme cMAP and prolonged supraphysiologic carotid blood flow. Both experimental groups experienced profound decreases in cMAP following deflation. Conclusions: With severe ongoing hemorrhage, P-REBOA increased survival time while maintaining cMAP and carotid flow at physiologic levels.
Document Details
- Document Type
- Technical Report
- Publication Date
- Sep 10, 2015
- Accession Number
- AD1023092
Entities
People
- Lucas Neff