{'fraction_non_alphanumeric': 0.0288659793814433, 'fraction_numerical': 0.015463917525773196, 'mean_word_length': 5.027950310559007, 'pattern_counts': {'":': 0, '<': 0, '<?xml version=': 0, '>': 4, 'https://': 0, 'lorem ipsum': 0, 'www.': 0, 'xml': 0}, 'pii_count': 0, 'substrings_counts': 0, 'word_list_counts': {'cursed_substrings.json': 0, 'profanity_word_list.json': 0, 'sexual_word_list.json': 0, 'zh_pornsignals.json': 0}}
IS CEREBRAL PERFUSION MAINTAINED DURING FULL AND PARTIAL REBOA IN HEMORRHAGIC SHOCK CONDITIONS?

BACKGROUND
Partial resuscitative endovascular balloon occlusion of the aorta (pREBOA) is a technology that occludes aortic flow and allows for controlled deflation and restoration of varying distal perfusion. Carotid artery flow rates (CFR) during partial deflation are unknown. Our aim was to measure CFR with the different pREBOA balloon volumes, and correlate those to the proximal mean arterial pressure (PMAP) and a handheld pressure monitoring device (COMPASS).


METHODS
Ten swine underwent a hemorrhagic injury model with carotid and iliac arterial pressures monitored via arterial lines. Carotid and aortic flow rates were monitored with doppler flow probes. A COMPASS was placed to monitor proximal pressure. The pREBOA was inflated for 15 mins then partially deflated for an aortic flow rate of 0.7L/min for 45 mins. It was then completely deflated. PMAPs and CFR were measured and correlation was evaluated. Correlation between CRF and COMPASS measurements was evaluated.


RESULTS
CFR increased 240% with full inflation. CFR was maintained at 100-150% of baseline across a wide range of partial deflation. After full deflation, CFR transiently decreased to 45-95% of baseline. There was strong positive correlation (r>0.85) between CFR and PMAP after full inflation, and positive correlation with partial inflation (r>0.7). CFR had strong correlation with the COMPASS with full REBOA (r>0.85) and positive correlation with pREBOA (r>0.65).


CONCLUSIONS
CFR is increased in a hemorrhagic model during full and partial inflation of the pREBOA, and corelates well with PMAP. Carotid perfusion appears maintained across a wide range of pREBOA deflation, and could be readily monitored with a handheld portable COMPASS device instead of a standard arterial line setup.


LEVEL OF EVIDENCE
Basic Science, no level of evidence required.