Location Is Everything: The Hemodynamic Effects of REBOA in Zone 1 versus Zone 3 of the Aorta

AbstractObjectivesResuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) is an emerging technology to augment proximal blood pressure during the resuscitation of patients with non-compressible torso hemorrhage. Currently, placement choice, supraceliac (Zone 1) versus infrarenal (Zone 3) aorta, depends upon injury patterns, but remains a highly debated topic. We sought to compare the proximal hemodynamic support provided by Zone 1 versus Zone 3 REBOA placement, and the degree of hemodynamic instability upon reperfusion following intervention.MethodsEighteen anesthetized swine underwent controlled hemorrhage of 25% total blood volume, followed by 45 minutes of Zone 1 REBOA, Zone 3 REBOA, or no intervention (control). They were then resuscitated with shed blood, aortic balloons were deflated, and 5 hours of critical care ensued prior to euthanasia. Physiologic parameters were recorded continuously, and blood was drawn for analysis at specified intervals. Significance was defined as p

from Emergency Medicine via xlomafota13 on Inoreader http://ift.tt/2FlF03i