Abstract text (incl. references and figure legends)
Background: As the inflation volume of REBOA balloon increases, blood pressure rises, but complications due to distal ischemia are induced. In this study, the method of reaching the target SBP using a vasopressor while maintaining a partial occlusion of a certain inflation volume was compared with the conventional method.
Method: Total 6 swine were subjected to a rapid 40 % blood loss of estimated total blood volume. The swine were randomized into 30% (R30), 60% (R60), and 100% (R100) inflation groups. REBOA was maintained for 60 minutes, then deflated and animals were monitored for additional 60 minutes. Resuscitation was performed with a target of SBP 90mmHg, and hemodynamics, administered fluid and vasopressor doses were recorded. Blood samples were analyzed at each stage of experiment (Figure 1).
Results: Mean proximal MAP during resuscitation period was higher in the R30 group (Figure 4). At each time point, the difference in the mean heart rate among groups was statistically significant (p = 0.002) (Figure 5). After post-hoc analysis, there were significant differences in the mean heart rate between R30 and R100 groups at deflation period (p = 0.002) (Table 2). The average amount of fluid and vasopressor infused was greater in R100 group, although statistical difference was not shown (Table 3). The BUN, creatinine, and lactate values of each group with significantly different at each time point (p = 0.037, p = 0.003, p = 0.009, respectively). The R30 group showed significantly lower mean lactate values compared to the R100 group 60 and 120 minutes after hemorrhage (p = 0.024, p = 0.002, respectively) (Table 4).
Conclusion: In a swine hemorrhagic shock model, the REBOA balloon 30% inflation group remained more hemodynamically stable compared to other groups and required less fluid and vasopressor during resuscitation. In addition, ischemia-reperfusion injury after REBOA balloon deflation seemed to be less in 30% inflation group with the lowest lactate level.
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