Document Detail


The impact of hypovolaemic shock on the aortic diameter in a porcine model.
MedLine Citation:
PMID:  20727795     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: To investigate the impact of hypovolaemic shock on the aortic diameter in a porcine model, and to determine the implications for the endovascular management of hypovolaemic patients with traumatic thoracic aortic injury (TTAI).
MATERIALS AND METHODS: The circulating blood volume of seven Yorkshire pigs was gradually lowered in 10% increments. At 40% volume loss, an endograft was deployed in the descending thoracic aorta, followed by gradual fluid resuscitation. Potential changes in aortic diameter during the experiment were recorded using intravascular ultrasound (IVUS).
RESULTS: The aortic diameter decreased significantly at all evaluated levels during blood loss. The ascending aortic diameter decreased on average with 38% after 40% blood loss (range 24-62%, p = 0.018), the descending thoracic aorta with 32% (range 18-52%, p = 0.018) and the abdominal aorta with 28% (range 15-39%, p = 0.018). The aortic diameters regained their initial size during fluid resuscitation.
CONCLUSION: The aortic diameter significantly decreases during blood loss in this porcine model. If these changes take place in hypovolaemic TTAI patients as well, it may have implications for thoracic endovascular aortic repair (TEVAR). Increased oversizing of the endograft, or additional computed tomography (CT) or IVUS imaging after fluid resuscitation for more adequate aortic measurements, may be needed in TTAI patients with considerable blood loss.
Authors:
F H W Jonker; H Mojibian; F J V Schlösser; D M Botta; J E Indes; F L Moll; B E Muhs
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2010-08-19
Journal Detail:
Title:  European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery     Volume:  40     ISSN:  1532-2165     ISO Abbreviation:  Eur J Vasc Endovasc Surg     Publication Date:  2010 Nov 
Date Detail:
Created Date:  2010-10-22     Completed Date:  2010-12-03     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9512728     Medline TA:  Eur J Vasc Endovasc Surg     Country:  England    
Other Details:
Languages:  eng     Pagination:  564-71     Citation Subset:  IM    
Copyright Information:
Copyright © 2010 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved.
Affiliation:
Section of Vascular Surgery and Interventional Radiology, Yale University School of Medicine, New Haven, CT 06510, USA.
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MeSH Terms
Descriptor/Qualifier:
Animals
Aorta, Thoracic / injuries,  physiopathology*,  surgery,  ultrasonography*
Blood Vessel Prosthesis
Blood Vessel Prosthesis Implantation
Disease Models, Animal
Fluid Therapy
Male
Shock, Hemorrhagic / physiopathology*,  therapy
Swine
Ultrasonography, Interventional

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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