Determining the Cardiovascular Effect of Partial versus Complete REBOA in a Porcine (Sus scrofa) Model of Hemorrhagic Shock.
Abstract
Objectives: The objective of this study was to characterize, quantify, and compare the effects of REBOA and Endovascular Variable Aortic Control (EVAC) on cardiac function. Methods: Eighteen swine underwent hemorrhage of 25 blood volume, followed by 45 minutes of REBOA, EVAC, or no intervention (control). Balloon volume in the EVAC arm was titrated to maintain aortic flow (AF) 300 mL/min. Animals were resuscitated with shed blood, intra-aortic balloons were deflated, and five hours of critical care ensued prior to euthanasia. Cardiac function was measured continuously with a Scisense Pressure-Volume Catheter (Transonic Systems Inc.) in the left ventricle. Results: There were no differences in cardiac output at the start of experiment (REBOA 5.33.6 L/min versus EVAC 4.11.4 L/min, p=0.39) or at the end of the 30 minute bleed period (REBOA 5.71.9 L/min versus EVAC 5.91.9 L/min, p=0.81). During the intervention, there were no differences in average cardiac output (REBOA 11.54.5 L/min versus EVAC 7.52.8 L/min, p=0.09) or maximal cardiac output (REBOA 14.55.3 L/min versus EVAC 9.33.1 L/min, p=0.08). During critical care, REBOA animals had higher cardiac output (10.25.3 L/min) compared to EVAC animals (6.22.9 L/min, p=0.02).Conclusion: This study demonstrates that although EVAC does not change the cardiac output required during the intervention, EVAC does allow for lower cardiac output during critical care when compared to complete REBOA.
Document Details
- Document Type
- Technical Report
- Publication Date
- Mar 09, 2018
- Accession Number
- AD1048689
Entities
People
- Emily M. Tibbits
Organizations
- David Grant USAF Medical Center