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Traumatic brain injury may worsen clinical outcomes after prolonged partial resuscitative endovascular balloon occlusion of the aorta in severe hemorrhagic shock model
| Content Provider | Scilit |
|---|---|
| Author | Williams, Aaron M. Bhatti, Umar F. Dennahy, Isabel S. Graham, Nathan J. Nikolian, Vahagn C. Chtraklin, Kiril Chang, Panpan Zhou, Jing Biesterveld, Ben E. Eliason, Jonathan Alam, Hasan B. |
| Copyright Year | 2019 |
| Description | Journal: The Journal of Trauma and Acute Care Surgery The use of partial resuscitative endovascular balloon occlusion of the aorta (pREBOA) in combined hemorrhagic shock (HS) and traumatic brain injury (TBI) has not been well studied. We hypothesized that the use of pREBOA in the setting of TBI would be associated with worse clinical outcomes. Female Yorkshire swine were randomized to the following groups: HS + TBI; HS + TBI + pREBOA; and HS + pREBOA, (n=5/cohort). Animals in the HS + TBI group were left in shock for a total of 2 hours, whereas animals assigned to pREBOA groups were treated with supraceliac pREBOA deployment (60 minutes) 1 hour into the shock period. All animals were then resuscitated, and physiologic parameters were monitored for six hours. Further fluid resuscitation and vasopressors were administered as needed. At the end of the observation period, brain hemispheric swelling (%) and lesion size (mm3) were assessed. Mortality was highest in the HS + TBI + pREBOA group (40% [2/5] vs 0% [0/5] in the other groups, p = 0.1). Severity of shock was greatest in the HS + TBI + pREBOA group, as defined by peak lactate levels and pH nadir (p Conclusions Prolonged application of pREBOA in the setting of TBI does not contribute to early worsening of brain lesion size and edema. However, the addition of TBI to HS + pREBOA may worsen the severity of shock. Providers should be aware of the potential physiologic sequelae induced by TBI. not applicable (preclinical study). |
| Related Links | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6715315/pdf |
| Ending Page | 423 |
| Page Count | 9 |
| Starting Page | 415 |
| ISSN | 21630755 |
| e-ISSN | 21630763 |
| DOI | 10.1097/ta.0000000000002149 |
| Journal | The Journal of Trauma and Acute Care Surgery |
| Issue Number | 3 |
| Volume Number | 86 |
| Language | English |
| Publisher | Ovid Technologies (Wolters Kluwer Health) |
| Publisher Date | 2019-03-01 |
| Access Restriction | Open |
| Subject Keyword | Journal: The Journal of Trauma and Acute Care Surgery |
| Content Type | Text |
| Resource Type | Article |
| Subject | Surgery Critical Care and Intensive Care Medicine |
