Sean Montgomery, MD
Assistant Professor
Duke University Medical Center
chapel hill, North Carolina, United States
Disclosure information not submitted.
Erica Peethumnongsin, MD
Assistant Professor
Duke University
Durham, North Carolina, United States
Disclosure information not submitted.
Ioana Antonescu, MD, MSc
n/a
Raleigh, North Carolina, United States
Disclosure information not submitted.
Brad Moore, PhD
Staff R&D Engineer
Kitware
chapel hill, North Carolina, United States
Disclosure information not submitted.
Title: Femoral Vessel Duplex in a Swine Model of Hemorrhagic Shock
Introduction: Physician Directed Point of Care Ultrasound (POCUS) of the Heart and Great Vessels (such as IVC collapsibility) Has Been Shown to Identify Hypovolemic Shock and Guide Therapy in the ICU. We Performed a Preclinical Study to see if Changes are Manifested in the Femoral Vessels During Hypovolemic Shock on Duplex Imaging, as the Femoral Vessels Represent an Easier Target for Less Experienced Ultrasound Operators and Potentially for Automated Interpretation by Artificial Intelligence Systems
Methods: A Preclinical Study in Swine Was Performed Using a Convenience Sample of Animals That Were Being Used in a Trauma Surgery Training Lab. The Animals Developed Progressive Unregulated Hemorrhage During the Lab. Three Swine Underwent Venous Duplex Studies of the Femoral Vessels Prior To Any Hemorrhage, Then at Two Points After the Start of Hemorrhage. Imaging was Done Using a Portable POCUS.
Results: Femoral Arterial Peak Systolic Velocity Decreased in All Animals with Hemorrhage, from Mean (SD) 77 (26) cm/s Pre hemorrhage to 42 (17) and 31 (15) cm/s at the Two Points Post Hemorrhage. Mean Venous Velocities Also Decreased with Hemorrhage (19, 10, 7 cm/s). Animals Were Given Positive Pressure Breaths, Which Resulted in a Venous Flow Decrease from 19 to 8 cm/s Pre hemorrhage and from 10 and 9 cm/s to 0 cm/s at Both Time Points After Hemorrhage.
Conclusion: In This Preclinical Study, Both Femoral Peak Systolic Velocity and Venous Velocity Decrease with Hemorrhage. Femoral Vessels Present an Easily Accessible Target for Noninvasive Hemodynamic Monitoring. Changes in Femoral Vessel Duplex Should Be Studied in Humans or a Larger Sample of Animals with Controlled Hemorrhage to See if Changes Appear in Early Hemorrhage Before the Onset of Obvious Hemorrhagic Shock.