Abstract
Introduction
Resuscitative endovascular balloon occlusion of the aorta (REBOA) in zone I increases
systemic blood pressure during cardiopulmonary resuscitation (CPR), while also obstructing
the blood flow to distal organs. The aim of the study was to compare the effects on
systemic blood pressure and visceral blood flow of REBOA-III (zone III, infrarenal)
and REBOA-I (zone I, supraceliac) during non-traumatic cardiac arrest and CPR.
Methods
Cardiac arrest was induced in 61 anesthetized pigs. Thirty-two pigs were allocated
to a hemodynamic study group where the primary outcomes were systemic arterial pressures
and 29 pigs were allocated to a blood flow study group where the primary outcomes
were superior mesenteric arterial (SMA) and internal carotid arterial (ICA) blood
flow. After 7–8 min of CPR with a mechanical compression device, REBOA-I, REBOA-III
or no aortic occlusion (control group) were initiated after randomization.
Results
Systemic mean and diastolic arterial pressures were statistically higher during CPR
with REBOA-I compared to REBOA-III (50 mmHg and 16 mmHg in REBOA-I vs 38 mmHg and
1 mmHg in REBOA-III). Systemic systolic, mean and diastolic arterial pressures were
statistically elevated during CPR in the REBOA-I group compared to the controls. The
SMA blood flow increased by 49% in REBOA-III but dropped to the levels of the controls
within minutes. The ICA blood flow increased the most in REBOA-I compared to REBOA-III
and the control group (54%, 19% and 0%, respectively).
Conclusion
In experimental non-traumatic cardiac arrest and CPR, REBOA-I increased systemic blood
pressures more than REBOA-III, and the potential enhancement of visceral organ blood
flow by REBOA-III was short-lived.
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Article info
Publication history
Published online: April 24, 2020
Accepted:
April 3,
2020
Received in revised form:
March 24,
2020
Received:
February 11,
2020
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© 2020 Published by Elsevier B.V.
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