• Kaeli J Yamashiro, Andrew M Wishy, Carl A Beyer, Harris W Kashtan, Laura A Galganski, J Kevin Grayson, M Austin Johnson, Jacob T Stephenson, and A Francois Trappey.
• Department of Surgery, University of California-Davis, Sacramento, CA; Clinical Investigation Facility, David Grant USAF Medical Center, Travis Air Force Base, Fairfield, CA. Electronic address: kjyamashiro@ucdavis.edu.
• J. Pediatr. Surg. 2020 Feb 1; 55 (2): 346-352.

BackgroundResuscitative endovascular balloon occlusion of the aorta (REBOA) has not been studied in children. We hypothesized that REBOA was feasible and would improve hemorrhage control and survival time, compared to no aortic occlusion, in a pediatric swine liver injury model.MethodsPediatric swine were randomized to Zone 1 REBOA or no intervention (control). Piglets underwent a partial liver amputation and free hemorrhage followed by either REBOA or no intervention for 30 min, then a damage control laparotomy and critical care for 4 h.ResultsCompared to control piglets (n = 5), REBOA piglets (n = 6) had less blood loss (34.0 ± 1.6 vs 61.3 ± 2.5 mL/kg, p < 0.01), higher end hematocrit (28.1 ± 2.1 vs 17.1 ± 4.1%, p = 0.03), higher end creatinine (1.4 ± 0.1 vs 1.2 ± 0.1 mg/dL, p = 0.05), higher end ALT and AST (56 ± 4 vs 32 ± 6 U/L, p = 0.01 and 155 ± 26 vs 69 ± 25 U/L, p = 0.05) and required more norepinephrine during critical care (1.4 ± 0.3 vs 0.3 ± 0.3 mg/kg, p = 0.04). All REBOA piglets survived, whereas 2 control piglets died, p = 0.10.ConclusionIn pediatric swine, 30 min of REBOA is feasible, decreases blood loss after liver injury and may improve survival.Level Of EvidenceLevel 1.Published by Elsevier Inc.

15 keywords...

hide…