Page 37 - JSOM Spring 2021

FIGURE 3 Laboratory values.

(A) (B)

(C) (D)

(E) (F)

(A) pH; (B) potassium; (C) lactate; (D) urea nitrogen; (E) creatinine; (F) myoglobin. T0 is start of randomized aorta occlusion.
CAO, continuous AAJT occlusion; OAO, overlapping aortic occlusion; SAO, sequential aortic occlusion.

these findings during human care. Swine have a more devel- potentially resulting in improper cannulation. Further studies
oped collateral system compared with humans, including the are needed to define clear guidelines for managing noncom-
well-developed subclavian-to-iliac mammary collateral system pressible torso hemorrhage in the austere environment.
that likely supplies the abdominal wall and perfusion below
the REBOA. 26,27 These collaterals are likely occluded with the Acknowledgments
AAJT, thus making a direct comparison with responses in a The authors would like to thank the staff of Bridge PTS and
human patient not ideal. the USAF 59th Clinical Investigations and Research Support
for technical assistance and laboratory support. The authors
would also like to acknowledge Justin Sleeter and Chris Har-
Conclusion
well for their contributions to this work.
Conversion of the AAJT to infrarenal REBOA is effective, with
each technique having physiologic advantages and disadvan- Funding
tages. Placement of a REBOA catheter in the presence of an Funding for this project was provided by the Air Force Medi-
inflated AAJT can make accessing the femoral artery difficult, cal Service’s RDT&E program

Conversion From AAJT to REBOA | 35