Traumatic brain injury may worsen clinical outcomes after prolonged partial resuscitative endovascular balloon occlusion of the aorta in severe hemorrhagic shock model
The Journal of Trauma and Acute Care Surgery Mar 10, 2019
Williams AM, et al. -Researchers sought to study the use of partial resuscitative endovascular balloon occlusion of the aorta (pREBOA) in combined hemorrhagic shock (HS) and traumatic brain injury (TBI) via randomizing female Yorkshire swine to the following groups: HS-TBI, HS-TBI-pREBOA, and HS-pREBOA (n = 5/cohort). For a total of 2 hours, they left animals in the HS-TBI group in shock, whereas they treated animals assigned to pREBOA groups with supraceliac pREBOA deployment (60 minutes) 1 hour into the shock period. Then all animals were resuscitated and monitored for physiologic parameters for 6 hours. They administered further fluid resuscitation and vasopressors as required. Findings show no early worsening of brain lesion size and edema in correlation with the prolonged application of pREBOA in the setting of TBI. However, the severity of shock may worsen with the addition of TBI to HS-pREBOA. They recommend providers to be informed of the potential physiologic sequelae induced by TBI.
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