Evaluation of Esmolol as an Adjunct to Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) in a Porcine (Sus scrofa) Model of Non Compressible Torso Hemorrhage

Abstract

Purpose of protocol; to evaluate if esmolol infusion during resuscitative endovascular balloon occlusion of the aorta (REBOA) could mitigate cardiac injury induced by high afterload and cardiac strain that occurs during aortic occlusion. Materials and methods: Swine were anesthetized and instrumented. The spleen was removed via midline celiotomy. Hemorrhagic shock was induced via removal of 25 percent of animals' estimated blood volume over 30 minutes through the brachial arterial line. At end of hemorrhage period, zone 1 balloon was inflated for 45 minutes; during the AO period, the esmolol infusion rate was titrated to maintain heart rate between 80 and 100 beats per minute in the intervention group. The esmolol infusion was discontinued at beginning of balloon deflation. Shed blood was transfused to the animal over 20 minutes at T65. In both groups, the aortic balloon was deflated over 10 minutes. Animals were cared for w/crystalloid boluses and norepinephrine until end of experiment. Results: The mean esmolol dose over the 45 minutes of occlusion was 225.1 +-48.9 (mu)g/kg.

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Document Details

Document Type
Technical Report
Publication Date
Apr 02, 2019
Accession Number
AD1072073

Entities

People

  • Carl A. Beyer

Organizations

  • David Grant USAF Medical Center

Tags

Communities of Interest

  • Biomedical

DTIC Thesaurus Topics

  • Abstracts
  • Air Force
  • Blood
  • Blood Volume
  • Diseases And Disorders
  • Emergency Treatment
  • Heart Rate
  • Hemorrhage
  • Hemorrhagic Shock
  • Infusions
  • Instructors
  • Intervention
  • Medical Personnel
  • Resuscitation
  • Survival
  • Technical Information Centers
  • Therapy
  • Training
  • Vascular System Injuries
  • Volume

Fields of Study

  • Medicine

Readers

  • Cardiovascular Physiology
  • Trauma Surgery or Emergency Medicine.