The Physiologic Effects of Increasing Durations of Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) in a Pediatric Swine (Sus scrofa) Hemorrhage Model
Abstract
Objectives: Evaluate the physiologic effects of 30min and 60min of REBOA. Methods: Pediatric swine weighing 20-30kg underwent splenectomy, a controlled 60% total blood volume hemorrhage over 30min, the Zone 1 REBOA for 60min (60R) or 30min (30R). Swine were resuscitated blood and received critical care for 240min. Results: Compared to baseline, end creatinine and creatinine kinase were elevated in 60R swine (n=5, 0.97 vs 1.7mg/dL, p<0.01 and 335.4 vs 961U/L, p<0.001, respectively), but not 30R swine (n=3, 0.91 vs 1.2mg/dL, p=0.06 and 423.7 vs 769.5U/L, p=0.15, respectively). During critical care, the 30R swine's pH, HCO3, base excess and lactate no longer differed from baseline, while at the end of critical care, the 60R swine continued to differ from baseline (7.4 vs 7.2, p<0.001, 30.4 vs 18.4mmol/L, p<0.0001, 5.6 vs -8.5mmol/L, p<0.0001, 2.4 vs 5.7mmol/L, p<0.001, respectively). There was no difference in survival in the 60R swine (60 ) and 30R swine (66.7 ), p=0.85. Conclusion: The physiologic effects of Zone 1 REBOA for 30min mostly resolve, whereas the effects of 60min persist and worsen after 4hrs of critical care. Sixty minutes of Zone 1 REBOA may be too long in children.
Document Details
- Document Type
- Technical Report
- Publication Date
- Jun 26, 2019
- Accession Number
- AD1077370
Entities
People
- Kaeli Yamashiro
Organizations
- David Grant USAF Medical Center