-
Tytuł:
-
The Effect of Chest Compression Location and Occlusion of the Aorta in a Traumatic Arrest Model.
-
Autorzy:
-
Anderson KL; Department of Emergency Medicine, Stanford University School of Medicine, Palo Alto, California. Electronic address: .
Morgan JD; San Antonio Military Medical Center, Fort Sam Houston, Texas.
Castaneda MG; CREST Research Program, Wilford Hall Ambulatory Surgical Center, Lackland AFB, Bexar County, Texas.
Boudreau SM; CREST Research Program, Wilford Hall Ambulatory Surgical Center, Lackland AFB, Bexar County, Texas.
Araña AA; United States Army Institute of Surgical Research, Fort Sam Houston, Texas.
Kohn MA; Department of Emergency Medicine, Stanford University School of Medicine, Palo Alto, California.
Bebarta VS; Department of Emergency Medicine, University of Colorado School of Medicine, Aurora, Colorado.
-
Źródło:
-
The Journal of surgical research [J Surg Res] 2020 Oct; Vol. 254, pp. 64-74. Date of Electronic Publication: 2020 May 15.
-
Typ publikacji:
-
Journal Article; Research Support, U.S. Gov't, Non-P.H.S.
-
Język:
-
English
-
Imprint Name(s):
-
Publication: New York, NY : Academic Press
Original Publication: Philadelphia [etc.]
-
MeSH Terms:
-
Aorta*
Pressure*
Thorax*
Balloon Occlusion/*methods
Heart Arrest/*etiology
Wounds and Injuries/*complications
Animals ; Cardiopulmonary Resuscitation/methods ; Disease Models, Animal ; Female ; Heart Arrest/therapy ; Heart Ventricles ; Hemodynamics ; Hemorrhage ; Prospective Studies ; Resuscitation/methods ; Sus scrofa
-
Contributed Indexing:
-
Keywords: Balloon occlusion; Cardiopulmonary resuscitation; Echocardiography; Hemodynamics; Survival; Trauma
-
Entry Date(s):
-
Date Created: 20200518 Date Completed: 20201029 Latest Revision: 20201029
-
Update Code:
-
20240105
-
DOI:
-
10.1016/j.jss.2020.03.026
-
PMID:
-
32417498
-
Background: Recent evidence demonstrates that closed chest compressions directly over the left ventricle (LV) in a traumatic cardiac arrest (TCA) model improve hemodynamics and return of spontaneous circulation (ROSC) when compared with traditional compressions. Resuscitative endovascular balloon occlusion of the aorta (REBOA) also improves hemodynamics and controls hemorrhage in TCA. We hypothesized that chest compressions located over the LV would result in improved hemodynamics and ROSC in a swine model of TCA using REBOA.
Materials and Methods: Transthoracic echo was used to mark the location of the aortic root (traditional location) and the center of the LV on animals (n = 26), which were randomized to receive chest compressions in one of the two locations. After hemorrhage, ventricular fibrillation was induced to simulate TCA. After a period of 10 min of ventricular fibrillation, basic life support (BLS) with mechanical cardiopulmonary resuscitation was initiated and performed for 10 min followed by advanced life support for an additional 10 min. REBOA balloons were inflated at 6 min into BLS. Hemodynamic variables were averaged during the final 2 min of the BLS and advanced life support periods. Survival was compared between this REBOA cohort and a control group without REBOA (no-REBOA cohort) (n = 26).
Results: There was no significant difference in ROSC between the two REBOA groups (P = 0.24). Survival was higher with REBOA group versus no-REBOA group (P = 0.02).
Conclusions: There was no difference in ROSC between LV and traditional compressions when REBOA was used in this swine model of TCA. REBOA conferred a survival benefit regardless of compression location.
(Copyright © 2020 Elsevier Inc. All rights reserved.)
