Gastroesophageal Resuscitative Occlusion of the Aorta (GROA)

Abstract

Natural Orifice Transluminal Endoscopic Surgery (NOTES) is an evolving surgical innovation, which allows for intra-cavitary surgeries to be performed with an endoscope passed through a natural orifice (mouth anus, vagina, urethra). It is the purpose of this proposal to leverage the concept of NOTES to develop a method of temporary aortic occlusion using an orally placed gastroesophageal device. This gastroesophageal resuscitative occlusion of the aorta (GROA) will be developed as a field bridge to more invasive and definitive means of control of non-compressible torso hemorrhage (NCTH) such as resuscitative endovascular balloon occlusion of the aorta (REBOA), angiography, and surgery. Hypothesis: The anatomical relationship between the esophagus and stomach to the descending thoracic and abdominal aorta will allow complete mechanical occlusion of the aorta through the stomach that can prolong short-term survival of severe NCTH. Specific Aims/Objectives: 1) Design and prototype GROA devices that can be orally placed into the stomach that mechanically produces complete occlusion of the aorta at or above the celiac artery and test the physiologic tolerance of GROA in comparison to REBOA in swine undergoing hemorrhage. 2) Test and compare GROA prototypes to REBOA for staunching severe NCTH in a large swine animal model of traumatic shock.3) Demonstrate tandem use of GROA followed by REBOA as an example of point-of-care in field prolonged field care (PFC) and prolonged damage control resuscitation (pDCR) in a swine model of severe NCTH. Experimental Approach: An iterative design and testing approach will be taken to develop a product, which leverages the anatomical relationship of the esophagus and stomach to the descending thoracic and abdominal aorta.

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Document Details

Document Type
Technical Report
Publication Date
Feb 01, 2019
Accession Number
AD1113086

Entities

People

  • Brendan M. Mccracken
  • Jeffery Plott
  • Kevin R. Ward
  • Mohamad H Tiba

Organizations

  • University of Michigan

Tags

DTIC Thesaurus Topics

  • Arteries
  • Blood
  • Cardiovascular Diseases
  • Cardiovascular Physiological Phenomena
  • Cardiovascular System
  • Chemistry
  • Data Analysis
  • Data Storage Systems
  • Department Of Defense
  • Electronic Mail
  • Health Services
  • Hemorrhagic Shock
  • Intellectual Property
  • Materials
  • Medical Personnel
  • Patient Care
  • Therapy
  • Veins
  • Vena Cava
  • Wounds And Injuries
  • X-Ray Computed Tomography

Fields of Study

  • Medicine

Readers

  • Trauma Surgery or Emergency Medicine.