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Endocrine Effects of Simulated Complete and Partial Aortic Occlusion in a Swine Model of Hemorrhagic Shock.
Mil Med ; 184(5-6): e298-e302, 2019 05 01.
Artigo em Inglês | MEDLINE | ID: mdl-30371879


Low distal aortic flow via partial aortic occlusion (AO) may mitigate ischemia induced by resuscitative endovascular balloon occlusion of the aorta (REBOA). We compared endocrine effects of a novel simulated partial AO strategy, endovascular variable aortic control (EVAC), with simulated REBOA in a swine model. MATERIALS AND


Aortic flow in 20 swine was routed from the supraceliac aorta through an automated extracorporeal circuit. Following liver injury-induced hemorrhagic shock, animals were randomized to control (unregulated distal flow), simulated REBOA (no flow, complete AO), or simulated EVAC (distal flow of 100-300 mL/min after 20 minutes of complete AO). After 90 minutes, damage control surgery, resuscitation, and full flow restoration ensued. Critical care was continued for 4.5 hours or until death.


Serum angiotensin II concentration was higher in the simulated EVAC (4,769 ± 624 pg/mL) than the simulated REBOA group (2649 ± 429) (p = 0.01) at 180 minutes. There was no detectable difference in serum renin [simulated REBOA 231.3 (227.9-261.4) pg/mL; simulated EVAC 294.1 (231.2-390.7) pg/mL; p = 0.27], aldosterone [simulated EVAC 629 (454-1098), simulated REBOA 777 (575-1079) pg/mL, p = 0.53], or cortisol (simulated EVAC 141 ± 12, simulated REBOA 127 ± 9 ng/mL, p = 0.34) concentrations between groups.


Simulated EVAC was associated with higher serum angiotensin II, which may have contributed to previously reported cardiovascular benefits. Future studies should evaluate the renal effects of EVAC and the concomitant therapeutic use of angiotensin II.





Texto completo: Disponível Coleções: Bases de dados internacionais Base de dados: MEDLINE Assunto principal: Aorta / Oclusão com Balão / Sistema Endócrino Aspecto clínico: Terapia Limite: Animais Idioma: Inglês Revista: Mil Med Ano de publicação: 2019 Tipo de documento: Artigo País de afiliação: Canadá