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European Journal of Trauma and Emergency Surgery

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04-01-2022 | Massage | Original Article

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

Authors: Joseph Edwards, Hossam Abdou, Neerav Patel, Eric Lang, Michael J. Richmond, Todd E. Rasmussen, Thomas M. Scalea, Jonathan J. Morrison

Published in: European Journal of Trauma and Emergency Surgery | Issue 3/2022

Abstract

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).

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Title: 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
Authors: Joseph Edwards
Hossam Abdou
Neerav Patel
Eric Lang
Michael J. Richmond
Todd E. Rasmussen
Thomas M. Scalea
Jonathan J. Morrison
Publication date: 04-01-2022
Publisher: Springer Berlin Heidelberg
Keywords: Massage
Thoracotomy
Published in: European Journal of Trauma and Emergency Surgery / Issue 3/2022
Print ISSN: 1863-9933
Electronic ISSN: 1863-9941
DOI: https://doi.org/10.1007/s00068-021-01810-0

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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

Abstract

Aim

Methods

Results

Conclusion

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Springer Medicine

Abstract

Aim

Methods

Results

Conclusion

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