Jin Xiaogao, Chu Qinjun, Bing Hailong, Li Fang, Bai Jingyue, Lou Junge, Sun Liwei, Zhang Chenxi, Lin Lin, Li Liumei, Wang Haibo, Zhou Zhanfeng, Zhang Junfeng, Lian Hongkai
Department of Anesthesiology, The Second Affiliated Hospital of Guangdong Medical University, Zhanjiang, Guangdong, China.
Department of Anesthesiology and Perioperative Medicine, Zhengzhou Central Hospital Affiliated to Zhengzhou University, Zhengzhou, China.
Front Bioeng Biotechnol. 2024 Apr 26;12:1340765. doi: 10.3389/fbioe.2024.1340765. eCollection 2024.
This study aimed to estimate the effects of the volume of preperitoneal balloon (PPB) on arterial and venous hemorrhage in a swine pelvic fracture model. Twenty-four swine were randomized into 0-mL, 500-mL, 800-mL, and 1000-mL intra-hematoma PPB groups. They were subjected to open-book pelvic fracture and reproducible injuries in the external iliac artery and vein. The pelvic binder and IH-PPBs with different volumes of fluid were applied to control the active hemorrhage after arterial and venous injuries. The survival time and rate during 60-min observation and digital subtraction angiography (DSA) images were the primary endpoints in this study. Secondary endpoints included survival rate within 70 min, peritoneal pressure, hemodynamics, blood loss, infusion fluid, blood pH, and lactate concentration. Our results indicated that the 800-mL and 1000-mL groups had a higher survival rate (0%, 50%, 100% and 100% for 0, 500, 800, and 1000-mL groups respectively; < 0.0001) and longer survival time (13.83 ± 2.64, 24.50 ± 6.29, 55.00 ± 6.33, and 60.00 ± 0.00 min for 0, 500, 800, and 1,000 groups respectively; < 0.0005) than the 0-mL or 500-mL groups during the 60 min observation. Contrastingly, survival rate and time were comparable between 800-mL and 1000-mL groups during the 60-min observation. The IH-PPB volume was associated with an increase in the pressure of the balloon and the preperitoneal pressure but had no effect on the bladder pressure. Lastly, the 1000-mL group had a higher mean arterial pressure and systemic vascular resistance than the 800-mL group. IH-PPB volume-dependently controls vascular bleeding after pelvic fracture in the swine model. IH-PPB with a volume of 800 mL and 1000 mL efficiently managed pelvic fracture-associated arterial and venous hemorrhage and enhanced survival time and rate in the swine model without evidences of visceral injury.
本研究旨在评估猪骨盆骨折模型中腹膜前球囊（PPB）容量对动脉和静脉出血的影响。将24头猪随机分为血肿内PPB容量为0 mL、500 mL、800 mL和1000 mL的四组。对其造成开放性骨盆骨折以及髂外动脉和静脉的可重复性损伤。应用骨盆固定带和不同液体容量的血肿内PPB来控制动脉和静脉损伤后的活动性出血。本研究的主要终点是60分钟观察期内的生存时间和生存率以及数字减影血管造影（DSA）图像。次要终点包括70分钟内的生存率、腹膜压力、血流动力学、失血量、输液量、血液pH值和乳酸浓度。我们的结果表明，在60分钟观察期内，800 mL和1000 mL组的生存率更高（0 mL、500 mL、800 mL和1000 mL组的生存率分别为0%、50%、100%和100%；P<0.0001），生存时间更长（0 mL、500 mL、800 mL和1000 mL组分别为13.83±2.64、24.50±6.29、55.00±6.33和60.00±0.00分钟；P<0.0005），高于0 mL或500 mL组。相反，在60分钟观察期内，800 mL和1000 mL组之间的生存率和生存时间相当。血肿内PPB容量与球囊压力和腹膜前压力的升高相关，但对膀胱压力无影响。最后，1000 mL组的平均动脉压和全身血管阻力高于800 mL组。在猪模型中，血肿内PPB容量可依剂量依赖性控制骨盆骨折后的血管出血。容量为800 mL和1000 mL的血肿内PPB可有效控制猪模型中骨盆骨折相关的动脉和静脉出血，并延长生存时间和提高生存率，且无内脏损伤迹象。
