Limited Survival Pilot Study to Evaluate Endovascular Perfusion Augmentation for Critical Care (EPACC) after Endovascular Intervention in a Porcine Model (sus scrofa) of Resuscitation following Long Bone Fracture and Hemorrhagic Shock
Abstract
Objectives: The objective of this pilot study was to develop a 24-hour survival model following the use of aortic occlusive technology in a swine model of hemorrhagic shock. Furthermore, the study compared the consequences of using endovascular perfusion augmentation versus standard critical care in this model. Methods: Anesthetized swine underwent pulmonary contusion, lower extremity fractures, and 30 hemorrhage. Animals were randomized to receive either: no intervention, endovascular perfusion augmentation, or standard critical care after 90 minutes of full or partial aortic occlusion. Animals were survived for 24 hours. Results: All animals in the control group (n=3) and partial aortic occlusion group (n=3) survived for the full 24 hours. No animals survived 24 hours after complete aortic occlusion (n=3), with a mean survival time of 6 hours. The use of automated endovascular perfusion augmentation in this model required massive fluid boluses of over 20 liters in a 12-hour period and led to elevated lactate concentrations (3.59 mmol/L) compared to animals without endovascular perfusion augmentation (2.89 mmol/L). Conclusion: This pilot study demonstrated that 24-hour survival after partial aortic occlusion is feasible in a swine model of hemorrhagic shock. Automated endovascular perfusion augmentation led to massive fluid resuscitation and did not improve outcomes.
Document Details
- Document Type
- Technical Report
- Publication Date
- Apr 02, 2019
- Accession Number
- AD1072090
Entities
People
- Carl A. Beyer
Organizations
- David Grant USAF Medical Center