PMID- 34446655
OWN - NLM
STAT- MEDLINE
DCOM- 20211215
LR  - 20230828
IS  - 2163-0763 (Electronic)
IS  - 2163-0755 (Linking)
VI  - 91
IP  - 6
DP  - 2021 Dec 1
TI  - Combatting ischemia reperfusion injury from resuscitative endovascular balloon 
      occlusion of the aorta using adenosine, lidocaine and magnesium: A pilot study.
PG  - 995-1001
LID - 10.1097/TA.0000000000003388 [doi]
AB  - BACKGROUND: Resuscitative endovascular balloon occlusion of the aorta (REBOA), a 
      minimally invasive alternative to resuscitative thoracotomy, has been associated 
      with significant ischemia reperfusion injury (IRI). Resuscitation strategies 
      using adenosine, lidocaine, and magnesium (ALM) have been shown to mitigate 
      similar inflammatory responses in hemorrhagic and septic shock models. This study 
      examined the effects of ALM on REBOA-associated IRI using a porcine model. 
      METHODS: Animals underwent a 20% controlled hemorrhage followed by 30 minutes of 
      supraceliac balloon occlusion. They were assigned to one of four groups: control 
      (n = 5), 4-hour ALM infusion starting at occlusion, 2-hour (n = 5) and 4-hour (n 
      = 5) interventional ALM infusions starting at reperfusion. Adenosine, lidocaine, 
      and magnesium cohorts received a posthemorrhage ALM bolus followed by their 
      respective ALM infusion. Primary outcomes for the study assessed physiologic and 
      hemodynamic parameters. RESULTS: Adenosine, lidocaine, and magnesium infusion 
      after reperfusion cohorts demonstrated a significant improvement in lactate, base 
      deficit, and pH in the first hour following systemic reperfusion. At study 
      endpoint, continuous ALM infusion initiated after reperfusion over 4 hours 
      resulted in an overall improved lactate clearance when compared with the 2-hour 
      and control cohorts. No differences in hemodynamic parameters were noted between 
      ALM cohorts and controls. CONCLUSION: Adenosine, lidocaine, and magnesium may 
      prove beneficial in mitigating the inflammatory response seen from 
      REBOA-associated IRI as evidenced by physiologic improvements early during 
      resuscitation. Despite this, further refinement should be sought to optimize 
      treatment strategies.
CI  - Copyright (c) 2021 Wolters Kluwer Health, Inc. All rights reserved.
FAU - Conner, Jeff
AU  - Conner J
AD  - From the Madigan Army Medical Center (J.C., D.L., T.H., I.J., J.K., M.E., J.B.), 
      Tacoma, Washington; Heart Trauma and Sepsis Research Laboratory, College of 
      Medicine and Dentistry (H.L., G.D.), James Cook University, Townsville, 
      Queensland, Australia; and Department of Surgery (M.E.), University of North 
      Carolina, Chapel Hill, North Carolina.
FAU - Lammers, Daniel
AU  - Lammers D
FAU - Holtestaul, Torbjorg
AU  - Holtestaul T
FAU - Jones, Ian
AU  - Jones I
FAU - Kuckelman, John
AU  - Kuckelman J
FAU - Letson, Hayley
AU  - Letson H
FAU - Dobson, Geoffrey
AU  - Dobson G
FAU - Eckert, Matthew
AU  - Eckert M
FAU - Bingham, Jason
AU  - Bingham J
LA  - eng
PT  - Journal Article
PL  - United States
TA  - J Trauma Acute Care Surg
JT  - The journal of trauma and acute care surgery
JID - 101570622
RN  - 0 (Anti-Inflammatory Agents)
RN  - 0 (Protective Agents)
RN  - 33X04XA5AT (Lactic Acid)
RN  - 98PI200987 (Lidocaine)
RN  - I38ZP9992A (Magnesium)
RN  - K72T3FS567 (Adenosine)
SB  - IM
MH  - Adenosine/*administration & dosage
MH  - Animals
MH  - Anti-Inflammatory Agents/administration & dosage
MH  - Aorta/surgery
MH  - *Balloon Occlusion/adverse effects/methods
MH  - Disease Models, Animal
MH  - Drug Therapy, Combination
MH  - Endovascular Procedures/instrumentation/methods
MH  - Hydrogen-Ion Concentration/drug effects
MH  - Lactic Acid/blood
MH  - Lidocaine/*administration & dosage
MH  - Magnesium/*administration & dosage
MH  - Protective Agents/administration & dosage
MH  - *Reperfusion Injury/etiology/metabolism/prevention & control
MH  - Resuscitation/*methods
MH  - Shock, Hemorrhagic/*therapy
MH  - Swine
MH  - Treatment Outcome
EDAT- 2021/08/28 06:00
MHDA- 2021/12/16 06:00
CRDT- 2021/08/27 06:09
PHST- 2021/08/28 06:00 [pubmed]
PHST- 2021/12/16 06:00 [medline]
PHST- 2021/08/27 06:09 [entrez]
AID - 01586154-202112000-00013 [pii]
AID - 10.1097/TA.0000000000003388 [doi]
PST - ppublish
SO  - J Trauma Acute Care Surg. 2021 Dec 1;91(6):995-1001. doi: 
      10.1097/TA.0000000000003388.