Background
Resuscitative balloon occlusion of the aorta (REBOA) is an endovascular hemostasis method used for the management of traumatic abdominal and pelvic hemorrhages. However, REBOA-associated ischemia-reperfusion injury (IRI) complication limits its blocking time. We hypothesized that mild therapeutic hypothermia (TH) would relieve IRI caused by prolonged zone 1 REBOA.
Methods
Ten pigs were anesthetized, intubated, and subsequently struck with the experimental sliding-chamber ballistic gun to inflict liver damage. Animals were randomized to hypothermia (60 min of Zone 1 REBOA with external cooling for 180 min, n = 5) or control (60 min of Zone 1 REBOA with no external cooling, n = 5). Physiological and laboratory parameters were monitored and assessed. Distal organs were obtained for histologic analysis.
Results
At 180 min, compared with the control, the hypothermia animals exhibited significantly increased pH and significantly reduced lactate (Lac), hemoglobin (Hb) and hematocrit (Hct) (all p < 0.05). The change of Lac from 0 to 180 min in hypothermia animals was less than that in the control (p = 0.02). The total bleeding in the control group was significantly less than the hypothermia (p < 0.01). In the hypothermia group, PT at 120 and 180 min was significantly longer than that at baseline (all p < 0.05). Compared with the control, animals in hypothermia group showed slighter pathological injury of the distal organs and significantly lower overall injury score (all p < 0.05).
Conclusions
Mild TH during prolonged Zone 1 REBOA offered extraordinary distal organ preservation, and decreased metabolic acidosis.