Resuscitative endovascular balloon occlusion of the aorta (REBOA) in a pediatric swine liver injury model: A pilot study.
J Pediatr Surg
; 55(2): 346-352, 2020 Feb.
Article
em En
| MEDLINE
| ID: mdl-31787320
ABSTRACT
BACKGROUND:
Resuscitative endovascular balloon occlusion of the aorta (REBOA) has not been studied in children. We hypothesized that REBOA was feasible and would improve hemorrhage control and survival time, compared to no aortic occlusion, in a pediatric swine liver injury model.METHODS:
Pediatric swine were randomized to Zone 1 REBOA or no intervention (control). Piglets underwent a partial liver amputation and free hemorrhage followed by either REBOA or no intervention for 30â¯min, then a damage control laparotomy and critical care for 4â¯h.RESULTS:
Compared to control piglets (nâ¯=â¯5), REBOA piglets (nâ¯=â¯6) had less blood loss (34.0⯱â¯1.6 vs 61.3⯱â¯2.5â¯mL/kg, pâ¯<â¯0.01), higher end hematocrit (28.1⯱â¯2.1 vs 17.1⯱â¯4.1%, pâ¯=â¯0.03), higher end creatinine (1.4⯱â¯0.1 vs 1.2⯱â¯0.1â¯mg/dL, pâ¯=â¯0.05), higher end ALT and AST (56⯱â¯4 vs 32⯱â¯6â¯U/L, pâ¯=â¯0.01 and 155⯱â¯26 vs 69⯱â¯25â¯U/L, pâ¯=â¯0.05) and required more norepinephrine during critical care (1.4⯱â¯0.3 vs 0.3⯱â¯0.3â¯mg/kg, pâ¯=â¯0.04). All REBOA piglets survived, whereas 2 control piglets died, pâ¯=â¯0.10.CONCLUSION:
In pediatric swine, 30â¯min of REBOA is feasible, decreases blood loss after liver injury and may improve survival. LEVEL OF EVIDENCE Level 1.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Oclusão com Balão
/
Procedimentos Endovasculares
/
Hemorragia
/
Fígado
Limite:
Animals
Idioma:
En
Ano de publicação:
2020
Tipo de documento:
Article