Olsen Markus Harboe, Olesen Niels D, Karlsson Michael, Holmlöv Theodore, Søndergaard Lars, Boutelle Martyn, Mathiesen Tiit, Møller Kirsten
Department of Neurointensive Care and Neuroanaesthesiology, Neuroscience Centre, Rigshospitalet, University of Copenhagen, Denmark.
Department of Anesthesiology, Centre of Cancer and Organ Diseases, Rigshospitalet, University of Copenhagen, Denmark.
Resuscitation. 2021 Mar;160:39-48. doi: 10.1016/j.resuscitation.2021.01.010. Epub 2021 Jan 19.
Resuscitative endovascular balloon occlusion of the aorta (REBOA) reportedly elevates arterial blood pressure (ABP) during non-traumatic cardiac arrest.
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.
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.
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.
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.
2017-15-0201-01371.
据报道，在非创伤性心脏骤停期间，复苏性血管内主动脉球囊阻断术（REBOA）可提高动脉血压（ABP）。
这项针对猪心脏骤停的随机、盲法试验评估了球囊充气两分钟后自动REBOA对ABP（主要终点）以及动脉血气值、脑血流动力学和代谢标志物的影响。
将20只麻醉猪随机分为REBOA充气组或假充气组（每组n = 10），随后插入有创监测设备和新型自动REBOA导管（NEURESCUE®导管和NEURESCUE®辅助设备）。通过心室起搏诱导心脏骤停。心脏骤停三分钟后开始心肺复苏，心脏骤停五分钟后自动REBOA充气或假充气（研究人员不知情）。
与假充气组相比，充气组充气后REBOA球囊上方的平均ABP更高（充气组：54（95%CI：43 - 65）mmHg；假充气组：44（33 - 55）mmHg；P = 0.06），舒张期ABP更高（充气组：38（29 - 47）mmHg；假充气组：26（20 - 33）mmHg；P = 0.02），动脉与颈静脉氧含量差更低（P = 0.04）。自主循环恢复后，充气组的平均ABP（充气组：111（95%CI：94 - 128）mmHg；假充气组：94（95%CI：65 - 123）mmHg；P = 0.04）、舒张期ABP（充气组：95（95%CI：78 - 113）mmHg；假充气组：78（95%CI：50 - 105）mmHg；P = 0.02）、脑灌注压（CPP）（P = 0.01）和脑组织氧张力（充气组：为基线的315（95%CI：139 - 491）%；假充气组：204（95%CI：75 - 333）%；P = 0.04）均高于假充气组。
在非创伤性心脏骤停猪模型中，REBOA充气可改善作为冠状动脉压力替代指标的中心舒张动脉压和脑灌注。
2017 - 15 - 0201 - 01371。
