Conversion of Abdominal Aortic and Junctional Tourniquet (AAJT) to Infrarenal Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) is Safe and Practical in a Swine Hemorrhage Model
Abstract
Two methods of controlling pelvic and inguinal hemorrhage are the Abdominal Aortic and Junctional Tourniquet (AAJT) and Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA). The AAJT can be applied quickly, but prolonged use may damage the bowel, inhibit ventilation, and obstruct surgical access. REBOA requires technical proficiency, but has fewer complications. Safe conversion of AAJT to REBOA would allow for field hemorrhage control with mitigation of the morbidity associated with prolonged AAJT use. Methods: Yorkshire male swine (n=17, 70-90kgs) underwent controlled 40% hemorrhage. Subsequently, AAJT was placed on the abdomen and inflated. After one hour, animals were allocated to an additional 30 minutes of AAJT inflation, (continuous AAJT, CA), REBOA placement with the AAJT inflated, (immediate REBOA; IR), or REBOA placement following AAJT removal (subsequent REBOA; SR). Following removal, animals were observed for 3.5 hours. Results. No significant differences in survival, blood pressure, or laboratory values were found following intervention. Conversion to REBOA was successful in all animals but one in the IR group. REBOA placement time was 4.32.9 min for IR and 4.11.8 min for SR (p=0.909). No animal had observable intestinal injury. Conclusions. Conversion of AAJT to infrarenal REBOA is safe and effective, but access may be difficult while the AAJT is applied.
Document Details
- Document Type
- Technical Report
- Publication Date
- Aug 03, 2020
- Accession Number
- AD1105193
Entities
People
- Chris L. Harwell
- David S. Kauvar
- Jason Rall
- Justin J. Sleeter
- Kyle S. Stigall
- Perry E. Blough
Organizations
- San Antonio Uniformed Services Health Education Consortium