The impact of hypovolaemic shock on the aortic diameter in a porcine model

F. H.W. Jonker, H. Mojibian, F. J.V. Schlösser, D. M. Botta, J. E. Indes, F. L. Moll, B. E. Muhs

Research output: Contribution to journalArticlepeer-review

19 Scopus citations

Abstract

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.

Original languageEnglish (US)
Pages (from-to)564-571
Number of pages8
JournalEuropean Journal of Vascular and Endovascular Surgery
Volume40
Issue number5
DOIs
StatePublished - Nov 2010
Externally publishedYes

Keywords

  • Aorta
  • Hypovolaemia
  • Intravascular ultrasonography
  • Shock
  • Swine
  • Trauma

ASJC Scopus subject areas

  • Surgery
  • Cardiology and Cardiovascular Medicine

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