Resuscitative endovascular balloon occlusion of the aorta (REBOA) in a pediatric swine liver injury model: A pilot study

Kaeli J. Yamashiro, Andrew M. Wishy, Carl A. Beyer, Harris W. Kashtan, Laura A. Galganski, J. Kevin Grayson, M. Austin Johnson, Jacob T. Stephenson, A. Francois Trappey

Research output: Contribution to journalArticlepeer-review

2 Scopus citations

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 30 min, then a damage control laparotomy and critical care for 4 h. Results: Compared to control piglets (n = 5), REBOA piglets (n = 6) had less blood loss (34.0 ± 1.6 vs 61.3 ± 2.5 mL/kg, p < 0.01), higher end hematocrit (28.1 ± 2.1 vs 17.1 ± 4.1%, p = 0.03), higher end creatinine (1.4 ± 0.1 vs 1.2 ± 0.1 mg/dL, p = 0.05), higher end ALT and AST (56 ± 4 vs 32 ± 6 U/L, p = 0.01 and 155 ± 26 vs 69 ± 25 U/L, p = 0.05) and required more norepinephrine during critical care (1.4 ± 0.3 vs 0.3 ± 0.3 mg/kg, p = 0.04). All REBOA piglets survived, whereas 2 control piglets died, p = 0.10. Conclusion: In pediatric swine, 30 min of REBOA is feasible, decreases blood loss after liver injury and may improve survival. Level of evidence: Level 1.

Original languageEnglish (US)
JournalJournal of pediatric surgery
DOIs
StateAccepted/In press - Jan 1 2019

Keywords

  • Pediatric abdominal trauma
  • Pediatric resuscitation balloon occlusion of the aorta
  • Pediatric trauma animal model
  • Resuscitative balloon occlusion of the aorta

ASJC Scopus subject areas

  • Surgery
  • Pediatrics, Perinatology, and Child Health

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