Esmolol reduces myocardial injury induced by resuscitative endovascular balloon occlusion of the aorta (REBOA) in a porcine model of hemorrhagic shock.

Injury
Guillaume L HoareauM Austin Johnson

Abstract

Resuscitative endovascular balloon occlusion of the aorta (REBOA) causes myocardial injury from increased aortic afterload and supraphysiologic cardiac output. However, pharmacologic methods to attenuate high cardiac output and reduce myocardial injury have not been explored. We hypothesized that the use of esmolol during REBOA would reduce myocardial injury. Ten pigs were anesthetized and instrumented. Following 25% total blood volume hemorrhage, animals underwent 45 min of supraceliac (zone 1) REBOA with or without titration of esmolol to maintain heart rate between 80 and 100 beats per minute. Following the REBOA interventions, animals underwent 275 min of standardized critical care. During REBOA, heart rate was significantly lower in the esmolol group compared to control animals (100 [88 - 112] vs 193 [172 - 203] beats/minute, respectively, p < 0.001) and the average mean arterial pressure (MAP) was lower in the esmolol group (88.0 [80.3-94.9] vs 135.1 [131.7-140.4] mmHg, respectively, p = 0.01). During the critical care phase, there were no differences in heart rate or MAP between groups. Animals in the intervention group received 237.9 [218.7-266.5] µg/kg of esmolol. There was a significant increase from baseline in serum...Continue Reading

References

Oct 11, 2005·Critical Care Medicine·Takeshi SuzukiJunzo Takeda
Oct 30, 2009·Critical Care : the Official Journal of the Critical Care Forum·Etienne de MontmollinDjillali Annane
Apr 6, 2013·Veterinary Pathology·K N Gibson-CorleyD K Meyerholz
Dec 23, 2017·The American Journal of Emergency Medicine·Ping LiuMalong Feng
Aug 21, 2018·Pilot and Feasibility Studies·Samuel M BrownUNKNOWN Esmolol to Control Adrenergic Storm in Septic Shock-ROLL-IN (ECASSS-R) study
May 31, 2019·The Journal of Trauma and Acute Care Surgery·Carl A BeyerMichael Austin Johnson

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