Hernández-García EF, García-Núñez LM

Language: Spanish
References: 10
Page: 62-70
PDF size: 1865.04 Kb.

ABSTRACT

Introduction: although literature recommends that total inflow occlusion maneuver (TIOM) should be instituted no longer than 1-3 minutes, a period through the occlusion to the blood flow could be sustained without hemodynamic or structural consequences remains unknown. Material and methods: experimental and comparative trial on biologic model of hemorrhagic shock. Three groups: TIOM sustained by 30, 60, and 90 seconds. Demographic, and hemodynamic variables, as well as myocardial histological changes were analyzed. Statistics-t test and ANOVA. Results: 30 standard canine models were included (10 per group). No differences between hemodynamics prior and after institution of TIOM were demonstrated. A significant difference on post-bleeding systolic blood pressure of B and C groups was detected (69 ± 22.3 versus 96 ± 21.7 mmHg; p = 0.04). When analyzing hemodynamics 30, 60, and 90 seconds after total inflow occlusion maneuver no significant difference among systolic blood pressure, median blood pressure and heart rate was demonstrated; diastolic blood pressure effectively showed a significant difference (B-46 ± 15 versus C-65 ± 18.4; p = 0.04). A significant difference in edema severity (A-0.0 ± 0.0 versus B-0.7 ± 1.0 [p = 0.001]; A-0.0 ± 0.0 versus C-3 ± 0.0 [p = ND] y B-0.7 ± 1.0 versus C-3 ± 0.0 [p < 0.0001]) and myocardial hemorrhage presence (A-0.0 ± 0.0 versus B-0.1 ± 0.3 [p = 0.3]; A-0.0 ± 0.0 versus C-1.0 ± 0.0 [p = ND] y B-0.1 ± 0.3 versus C-1.0 ± 0.0 [p < 0.0001]) was demonstrated among the totality of groups. Discussion: total inflow occlusion maneuver facilitates the reparation of atriocaval junction lacerations. It is supposed to be abbreviated leading to decrease myocardial structural alterations, what could be proved on the basis of this study. Conclusion: although a relationship between hemodynamic derangement and length of total inflow occlusion maneuver was not established, myocardial edema and the presence of hemorrhage were directly related to this duration.

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