Aim

of the study

Resuscitative endovascular balloon occlusion of the aorta (REBOA), originally designed to block blood flow to the distal part of the aorta by placing a balloon in trauma patients, has recently been shown to increase coronary perfusion in cardiac arrest patients. This study evaluated the effect of REBOA on aortic pressure and coronary perfusion pressure (CPP) in non-traumatic out of-hospital cardiac arrest (OHCA) patients.

Methods

Adult OHCA patients with cerebral performance category 1 or 2 prior to cardiac arrest, and without evidence of aortic disease, were enrolled from January to December 2021. Aortic pressure and right atrial pressure were measured before and after balloon occlusion. The CPP was calculated using the measured aortic and right atrial pressures, and the values before and after the balloon occlusion were compared.

Results

Fifteen non-traumatic OHCA patients were enrolled in the study. The median call to balloon time was 46.0 (IQR, 38.0–54.5) min. The median CPP before and after balloon occlusion was 13.5 (IQR, 5.8–25.0) and 25.2 (IQR, 12.0–44.6) mmHg, respectively (P = 0.001). The median increase in the estimated CPP after balloon occlusion was 86.7%.

Conclusions

The results of this study suggest that REBOA may increase the CPP during cardiopulmonary resuscitation in patients with non-traumatic OHCA. Additional studies are needed to investigate the effect on clinical outcomes.

中文翻译：

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复苏性血管内主动脉阻塞 (REBOA) 作为增加非创伤性院外心脏骤停患者冠状动脉灌注压的机械方法

目标

研究的

复苏性血管内球囊闭塞主动脉 (REBOA)，最初旨在通过在创伤患者中放置球囊来阻止血液流向主动脉远端，最近已证明可增加心脏骤停患者的冠状动脉灌注。本研究评估了 REBOA 对非创伤性院外心脏骤停 (OHCA) 患者的主动脉压和冠状动脉灌注压 (CPP) 的影响。

方法

于 2021 年 1 月至 2021 年 12 月招募了心脏骤停前脑功能为 1 或 2 类且无主动脉疾病证据的成人 OHCA 患者。在球囊闭塞前后测量了主动脉压和右心房压。使用测量的主动脉和右心房压力计算 CPP，并比较球囊闭塞前后的值。

结果

15 名非创伤性 OHCA 患者参加了该研究。呼叫气球时间的中位数为 46.0 (IQR, 38.0–54.5) 分钟。球囊闭塞前后的中位 CPP 分别为 13.5（IQR，5.8-25.0）和 25.2（IQR，12.0-44.6）mmHg（P = 0.001）。球囊闭塞后估计 CPP 的中位数增加为 86.7%。

结论

本研究结果表明，REBOA 可能会增加非创伤性 OHCA 患者心肺复苏期间的 CPP。需要更多的研究来调查对临床结果的影响。