PMID- 34984495
OWN - NLM
STAT- MEDLINE
DCOM- 20220616
LR  - 20220616
IS  - 1863-9941 (Electronic)
IS  - 1863-9933 (Linking)
VI  - 48
IP  - 3
DP  - 2022 Jun
TI  - Open chest selective aortic arch perfusion vs open cardiac massage as a means of 
      perfusion during in exsanguination cardiac arrest: a comparison of coronary 
      hemodynamics in swine.
PG  - 2089-2096
LID - 10.1007/s00068-021-01810-0 [doi]
AB  - AIM: To describe and compare the aortic-right atrial pressure (AoP-RAP) gradients 
      and mean coronary perfusion pressures (CPPs) generated during open chest 
      selective aortic arch perfusion (OCSAAP) with those generated during open cardiac 
      massage (OCM) in hypovolemic swine. METHODS: Ten male Hanford swine utilized in a 
      prior poly-trauma study were included in the study. Animals were rendered 
      hypovolemic via a 30% volume bleed. Upon confirmation of death, animals underwent 
      immediate clamshell thoracotomy and aortic cross-clamping followed by 5 min of 
      OCM. A catheter suitable for OCSAAP was then inserted into the aorta and animals 
      underwent 1 min of OCSAAP at a rate of 10 mL/kg/min. Aortic and right atrial 
      pressures were recorded continuously using solid-state blood pressure catheters. 
      Representative 10-s intervals from each resuscitation method were extracted. 
      Hemodynamic parameters including AoP-RAP gradients and CPPs were calculated and 
      compared. RESULTS: At baseline, time from death to intervention was significantly 
      shorter for OCM. However, mean CPPs and AoP-RAP gradients were significantly 
      higher in animals undergoing OCSAAP. 98% of OCSAAP segments had a mean CPP > 15, 
      compared to 35% of OCM intervals. While OCM had a significant negative 
      correlation between time to intervention and maximum CPP, this correlation was 
      not significant for OCSAAP. CONCLUSION: OCSAAP generates favorable and 
      potentially time-resistant pressure gradients when compared to those generated by 
      OCM. Further investigation of the technique of OCSAAP is warranted, as it may 
      have potential utility as a therapy during resuscitative thoracotomy (RT).
CI  - (c) 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany.
FAU - Edwards, Joseph
AU  - Edwards J
AUID- ORCID: 0000-0001-7462-8456
AD  - Adams Cowley Shock Trauma Center, University of Maryland Medical System, 22 S. 
      Greene Street, Baltimore, MD, 21201, USA.
FAU - Abdou, Hossam
AU  - Abdou H
AD  - Adams Cowley Shock Trauma Center, University of Maryland Medical System, 22 S. 
      Greene Street, Baltimore, MD, 21201, USA.
FAU - Patel, Neerav
AU  - Patel N
AD  - Adams Cowley Shock Trauma Center, University of Maryland Medical System, 22 S. 
      Greene Street, Baltimore, MD, 21201, USA.
FAU - Lang, Eric
AU  - Lang E
AD  - Adams Cowley Shock Trauma Center, University of Maryland Medical System, 22 S. 
      Greene Street, Baltimore, MD, 21201, USA.
FAU - Richmond, Michael J
AU  - Richmond MJ
AD  - Adams Cowley Shock Trauma Center, University of Maryland Medical System, 22 S. 
      Greene Street, Baltimore, MD, 21201, USA.
FAU - Rasmussen, Todd E
AU  - Rasmussen TE
AD  - Uniformed Services University of the Health Sciences, Bethesda, MD, USA.
FAU - Scalea, Thomas M
AU  - Scalea TM
AD  - Adams Cowley Shock Trauma Center, University of Maryland Medical System, 22 S. 
      Greene Street, Baltimore, MD, 21201, USA.
FAU - Morrison, Jonathan J
AU  - Morrison JJ
AD  - Adams Cowley Shock Trauma Center, University of Maryland Medical System, 22 S. 
      Greene Street, Baltimore, MD, 21201, USA. jonathan.morrison@som.umaryland.edu.
LA  - eng
GR  - HU00011920072/Uniformed Services University of the Health Sciences/
PT  - Journal Article
DEP - 20220104
PL  - Germany
TA  - Eur J Trauma Emerg Surg
JT  - European journal of trauma and emergency surgery : official publication of the 
      European Trauma Society
JID - 101313350
SB  - IM
MH  - Animals
MH  - Aorta, Thoracic
MH  - Exsanguination
MH  - *Heart Arrest/therapy
MH  - *Heart Massage/methods
MH  - Hemodynamics
MH  - Humans
MH  - Hypovolemia
MH  - Male
MH  - Perfusion
MH  - Swine
OTO - NOTNLM
OT  - Cardiac arrest
OT  - Cardiac massage
OT  - Exsanguination
OT  - Resuscitative thoracotomy
OT  - Selective aortic arch perfusion
EDAT- 2022/01/06 06:00
MHDA- 2022/06/18 06:00
CRDT- 2022/01/05 06:02
PHST- 2021/06/09 00:00 [received]
PHST- 2021/10/25 00:00 [accepted]
PHST- 2022/01/06 06:00 [pubmed]
PHST- 2022/06/18 06:00 [medline]
PHST- 2022/01/05 06:02 [entrez]
AID - 10.1007/s00068-021-01810-0 [pii]
AID - 10.1007/s00068-021-01810-0 [doi]
PST - ppublish
SO  - Eur J Trauma Emerg Surg. 2022 Jun;48(3):2089-2096. doi: 
      10.1007/s00068-021-01810-0. Epub 2022 Jan 4.