A Comparison of Zone 3 Resuscitative Endovascular Balloon Occlusion of the Aorta to the Abdominal Aortic and Junctional Tourniquet AAJT in a Lethal Pelvic Injury Swine Model
Abstract
Traumatic injuries to the pelvis and high junctional injuries are difficult to treat in the field; however, Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) and the Abdominal Aortic and Junctional Tourniquet (AAJT) constitute two promising treatment modalities. The aim of this study is to use a large animal model of pelvic hemorrhage to compare the survival, hemostatic, hemodynamic, and metabolic profile of both techniques. Yorkshire swine (N=10, 70-90 kg) underwent uncontrolled hemorrhage of the femoral artery by arteriotomy. Animals were randomly allocated to either REBOA or AAJT. After one hour, the injured femoral artery was ligated to simulate definitive hemostasis followed by a second Hextend bolus and device removal. Animals were observed for two more hours. Physiological data was collected throughout the experiments and compared between groups. No differences were found between groups with regards to pretreatment blood loss or blood chemistries. Both techniques effectively controlled hemorrhage in all animals, with no difference in mortality. During the 60-minute treatment phase, the AAJT group had a higher lactate level and MAP compared to the REBOA group (repeated measures ANOVA; p<0.05). Despite mechanistic differences between REBOA and the AAJT, both techniques achieve a similar hemostatic, hemodynamic and metabolic profile.
Document Details
- Document Type
- Technical Report
- Publication Date
- Dec 11, 2017
- Accession Number
- AD1067798
Entities
People
- Elliot Ross
- Jason M. Rall
- Jonathan Morrison
- Joseph K Maddry
- Theodore Redman
Organizations
- 59th Medical Wing