Organ ischemia during partial resuscitative endovascular balloon occlusion of the aorta: Dynamic 4D Computed tomography in swine

被引：14

作者：

Matsumura, Yosuke ^{[1
]}

Higashi, Akiko ^{[1
]}

Izawa, Yoshimitsu ^{[2
,3
]}

Hishikawa, Shuji ^{[4
]}

Kondo, Hiroshi ^{[5
]}

Reva, Viktor ^{[6
]}

Oda, Shigeto ^{[1
]}

Matsumoto, Junichi ^{[7
]}

机构：

[1] Chiba Univ, Grad Sch Med, Dept Emergency & Crit Care Med, Chiba, Japan

[2] Saiseikai Utsunomiya Hosp, Dept Emergency & Crit Care Med, Utsunomiya, Tochigi, Japan

[3] Jichi Med Univ, Dept Emergency & Crit Care Med, Shimotsuke, Tochigi, Japan

[4] Jichi Med Univ, Ctr Dev Adv Med Technol, Shimotsuke, Tochigi, Japan

[5] Teikyo Univ, Sch Med, Dept Radiol, Itabashi Ku, Tokyo, Japan

[6] Ulitsa Akad Lebedeva, Kirov Mil Med Acad, Dept War Surg, St Petersburg, Russia

[7] St Marianna Univ, Dept Emergency & Crit Care Med, Sch Med, Kawasaki, Kanagawa, Japan

来源：

SCIENTIFIC REPORTS | 2020年 / 10卷 / 01期

基金：

日本学术振兴会;

关键词：

CT PERFUSION; GOLDEN HOUR; INJURY; LIVER; BRAIN; REBOA; MODEL;

D O I：

10.1038/s41598-020-62582-y

中图分类号：

O [数理科学和化学]; P [天文学、地球科学]; Q [生物科学]; N [自然科学总论];

学科分类号：

07 ; 0710 ; 09 ;

摘要：

Resuscitative endovascular balloon occlusion of the aorta (REBOA) increases proximal pressure, and simultaneously induces distal ischemia. We aimed to evaluate organ ischemia during partial REBOA (P-REBOA) with computed tomography (CT) perfusion in a swine model. The maximum balloon volume was recorded as total REBOA when the distal pulse pressure ceased. The animals (n = 4) were scanned at each 20% of the maximum balloon volume, and time-density curve (TDC) were analysed at the aorta, portal vein (PV), liver parenchyma, and superior mesenteric vein (SMV, indicating mesenteric perfusion). The area under the TDC (AUTDC), the time to peak (TTP), and four-dimensional volume-rendering images (4D-VR) were evaluated. The TDC of the both upper and lower aorta showed an increased peak and delayed TTP. The TDC of the PV, liver, and SMV showed a decreased peak and delayed TTP. The dynamic 4D-CT analysis suggested that organ perfusion changes according to balloon volume. The AUTDC at the PV, liver, and SMV decreased linearly with balloon inflation percentage to the maximum volume. 4D-VR demonstrated the delay of the washout in the aorta and retrograde flow at the inferior vena cava in the highly occluded status.

引用

页数：11

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