Page 35 - JSOM Spring 2021

TABLE 1 Baseline, Post Hemorrhage, and Post AAJT Values
Value CAO OAO SAO p value
n 5 6 6 —
Weight (kg) 81.0 ± 10.4 84.6 ± 5.6 81.0 ± 6.5 0.523
Baseline
MAP (mmHg) 61.0 ± 8.2 62.0 ± 5.0 66.3 ± 3.4 0.278
HR (bpm) 97± 9 92 ± 11 95 ± 13 0.728
EtCO (mmHg) 41.6 ± 3.2 42.0 ± 3.5 38.5 ± 2.2 0.125
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pH 7.508 ± 0.058 7.492 ± 0.053 7.539 ± 0.042 0.374
K (mmol/L) 4.03 ± 0.51 3.85 ± 0.26 3.76 ± 0.23 0.586
Lactate (mmol/L) 1.79 ± 0.21 1.72 ± 0.70 2.07 ± 0.62 0.871
Post Hemorrhage
MAP (mmHg) 43.0 ± 10.5 41.8 ± 12.2 40.8 ± 12.1 0.955
HR (bpm) 167 ± 36 139 ± 31 161 ± 26 0.303
EtCO (mmHg) 37.8 ± 2.7 37.2 ± 5.1 35.0 ± 5.3 0.577
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pH 7.499 ± 0.022 7.506 ± 0.033 7.536 ± 0.049 0.178
K (mmol/L) 4.30 ± 0.57 4.00 ± 0.50 4.14 ± 0.25 0.746
Lactate (mmol/L) 2.53 ± 0.58 2.05 ± 0.82 2.46 ± 0.49 0.960
Hemorrhage (%EBV) 34.7 ± 7.1 35.9 ± 4.2 35.3 ± 4.0 0.532
Post 60-min AAJT
MAP (mmHg) 65.8 ± 21.4 67.1 ± 17.9 69.8 ± 16.4 0.933
HR (bpm) 180 ± 40 161 ± 42 181 ± 17 0.566
EtCO (mmHg) 42.8 ± 2.4 42.5 ± 6.2 41.3 ± 4.0 0.852
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pH 7.478 ± 0.042 7.450 ± 0.079 7.460 ± 0.059 0.868
K (mmol/L) 4.30 ± 0.48 4.30 ± 0.50 4.08 ± 0.41 0.966
Lactate (mmol/L) 3.29 ± 1.3 4.03 ± 1.1 3.88 ± 1.5 0.688
CAO, continuous AAJT occlusion; EtCO , end tidal CO ; HR, heart rate; MAP, mean arterial pressure; OAO, overlapping aortic occlusion; SAO,
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sequential aortic occlusion.
Data are mean ± SD.
the rise of EtCO (Table 2) and indirectly by the trend toward venous flow, and affects collateral as well as major vessels. In
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lower lactate levels in the SAO group. Additionally, the lapse comparison, Zone 3 REBOA specifically occludes the infra-
of occlusion could allow for the potential for continued hem- renal aorta. This allows for continued collateral arterial cir-
orrhage during that time. culation and preserves venous outflow. Despite these major
methodologic differences and the transient hemodynamic vari-
Although both the AAJT and REBOA occlude antegrade major ation seen with SAO, we observed no significant physiologic
pelvic arterial flow, their methods of occlusion are drastically differences between groups. The hyperkalemia and lactic aci-
different. The AAJT produces extrinsic compression across dosis observed in this study are consistent with the metabolic
the lower abdomen, resulting in occlusion of both arterial and derangements noted in prior studies and are associated with

TABLE 2 Select Values During and Shortly After Conversion to REBOA
Value CAO OAO SAO p value
Success n (%) — 5/6 (83%) 6/6 (100%) 0.999
Time (min) — 4.3 ± 2.9 4.1 ± 1.8 0.909
Values obtained proximal to occlusion
Carotid MAP (mmHg) - Nadir 63.4 ± 21.2 60.8 ± 19.1 43.6 ± 6.6 0.172
EtCO 2 (mmHg) - Peak 42.8 ± 2.4 44.2 ± 8.3 57.5 ± 6.5 0.003**
Pectoralis StO 2 (%) 67.8 ± 4.6*** 71.0 ± 12.9*** 53.8 ± 5.3 0.010*
Left Flank StO 2 (%) 53.2 ± 10.5 56.2 ± 13.8 43.3 ± 8.3 0.153
Values obtained distal to occlusion
Femoral Artery Pressure(mmHg) - Peak 26.2 ± 7.2**** 34.5 ± 16.6**** 60.7 ± 12.4 0.0014**
Left Thigh StO (%) 16.5 ± 3.0*** 22.5 ± 10.9 39.7 ± 18.5 0.0380*
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Right Thigh StO (%) 15.6 ± 1.3**** 21.8 ± 8.2**** 48.3 ± 15.1 0.0002**
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Values obtained shortly after conversion

EtCO 2 (mmHg) - Peak 46.2 ± 2.0**** 51.0 ± 6.7**** 61.5 ± 5.4 0.0008**
Carotid MAP (mmHg) - Peak 66.8 ± 20.7*** 77.5 ± 22.0 105.6 ± 21.4 0.0343*
CAO, continuous AAJT occlusion; EtCO , end title CO ; MAP, mean arterial pressure; OAO, overlapping aortic occlusion; SAO, sequential
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aortic occlusion; StO 2 , skeletal muscle tissue oxygenation.
*p < .05; **p < .01; ***p < .05 vs SAO; ****p < .01 vs SAO.
Data are mean ± SD.
Conversion From AAJT to REBOA | 33