Randomized blinded trial of automated REBOA during CPR in a porcine model of cardiac arrest
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Randomized blinded trial of automated REBOA during CPR in a porcine model of cardiac arrest. / Olsen, Markus Harboe; Olesen, Niels D.; Karlsson, Michael; Holmlöv, Theodore; Søndergaard, Lars; Boutelle, Martyn; Mathiesen, Tiit; Møller, Kirsten.
I: Resuscitation, Bind 160, 2021, s. 39-48.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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TY - JOUR
T1 - Randomized blinded trial of automated REBOA during CPR in a porcine model of cardiac arrest
AU - Olsen, Markus Harboe
AU - Olesen, Niels D.
AU - Karlsson, Michael
AU - Holmlöv, Theodore
AU - Søndergaard, Lars
AU - Boutelle, Martyn
AU - Mathiesen, Tiit
AU - Møller, Kirsten
PY - 2021
Y1 - 2021
N2 - Background: Resuscitative endovascular balloon occlusion of the aorta (REBOA) reportedly elevates arterial blood pressure (ABP) during non-traumatic cardiac arrest. Objectives: This randomized, blinded trial of cardiac arrest in pigs evaluated the effect of automated REBOA two minutes after balloon inflation on ABP (primary endpoint) as well as arterial blood gas values and markers of cerebral haemodynamics and metabolism. Methods: Twenty anesthetized pigs were randomized to REBOA inflation or sham-inflation (n = 10 in each group) followed by insertion of invasive monitoring and a novel, automated REBOA catheter (NEURESCUE® Catheter & NEURESCUE® Assistant). Cardiac arrest was induced by ventricular pacing. Cardiopulmonary resuscitation was initiated three min after cardiac arrest, and the automated REBOA was inflated or sham-inflated (blinded to the investigators) five min after cardiac arrest. Results: In the inflation compared to the sham group, mean ABP above the REBOA balloon after inflation was higher (inflation: 54 (95%CI: 43–65) mmHg; sham: 44 (33–55) mmHg; P = 0.06), and diastolic ABP was higher (inflation: 38 (29–47) mmHg; sham: 26 (20–33) mmHg; P = 0.02), and the arterial to jugular oxygen content difference was lower (P = 0.04). After return of spontaneous circulation, mean ABP (inflation: 111 (95%CI: 94–128) mmHg; sham: 94 (95%CI: 65–123) mmHg; P = 0.04), diastolic ABP (inflation: 95 (95%CI: 78−113) mmHg; sham: 78 (95%CI: 50−105) mmHg; P = 0.02), CPP (P = 0.01), and brain tissue oxygen tension (inflation: 315 (95%CI: 139−491)% of baseline; sham: 204 (95%CI: 75−333)%; P = 0.04) were higher in the inflation compared to the sham group. Conclusion: Inflation of REBOA in a porcine model of non-traumatic cardiac arrest improves central diastolic arterial pressure as a surrogate marker of coronary artery pressure, and cerebral perfusion. Institutional protocol number: 2017-15-0201-01371.
AB - Background: Resuscitative endovascular balloon occlusion of the aorta (REBOA) reportedly elevates arterial blood pressure (ABP) during non-traumatic cardiac arrest. Objectives: This randomized, blinded trial of cardiac arrest in pigs evaluated the effect of automated REBOA two minutes after balloon inflation on ABP (primary endpoint) as well as arterial blood gas values and markers of cerebral haemodynamics and metabolism. Methods: Twenty anesthetized pigs were randomized to REBOA inflation or sham-inflation (n = 10 in each group) followed by insertion of invasive monitoring and a novel, automated REBOA catheter (NEURESCUE® Catheter & NEURESCUE® Assistant). Cardiac arrest was induced by ventricular pacing. Cardiopulmonary resuscitation was initiated three min after cardiac arrest, and the automated REBOA was inflated or sham-inflated (blinded to the investigators) five min after cardiac arrest. Results: In the inflation compared to the sham group, mean ABP above the REBOA balloon after inflation was higher (inflation: 54 (95%CI: 43–65) mmHg; sham: 44 (33–55) mmHg; P = 0.06), and diastolic ABP was higher (inflation: 38 (29–47) mmHg; sham: 26 (20–33) mmHg; P = 0.02), and the arterial to jugular oxygen content difference was lower (P = 0.04). After return of spontaneous circulation, mean ABP (inflation: 111 (95%CI: 94–128) mmHg; sham: 94 (95%CI: 65–123) mmHg; P = 0.04), diastolic ABP (inflation: 95 (95%CI: 78−113) mmHg; sham: 78 (95%CI: 50−105) mmHg; P = 0.02), CPP (P = 0.01), and brain tissue oxygen tension (inflation: 315 (95%CI: 139−491)% of baseline; sham: 204 (95%CI: 75−333)%; P = 0.04) were higher in the inflation compared to the sham group. Conclusion: Inflation of REBOA in a porcine model of non-traumatic cardiac arrest improves central diastolic arterial pressure as a surrogate marker of coronary artery pressure, and cerebral perfusion. Institutional protocol number: 2017-15-0201-01371.
KW - Advanced life support
KW - Blood pressure
KW - Brain tissue oxygen tension
KW - Non-traumatic cardiac arrest
KW - REBOA
U2 - 10.1016/j.resuscitation.2021.01.010
DO - 10.1016/j.resuscitation.2021.01.010
M3 - Journal article
C2 - 33482264
AN - SCOPUS:85099608296
VL - 160
SP - 39
EP - 48
JO - Resuscitation
JF - Resuscitation
SN - 0300-9572
ER -
ID: 256070813