Balloon occlusion of the right main bronchus in an ovine model provides sufficient time for emergent interventions in massive pulmonary embolism

Yong Fan, Yang Liu, Rahmi Oklu, Neng Shu He, Ping li, Qi Wu, Amy Deipolyi, Stephan Wicky, Ho Young Song

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

PURPOSE: Massive pulmonary embolism (PE) causes hemodynamic compromise and is associated with a high rate of mortality. We sought to create a model of massive PE and to determine whether occlusion of the right main bronchus could mitigate the physiological effects of massive PE in this model. MATERIALS AND METHODS: We used 27 female sheep to generate a model of massive PE by either autologous blood clot injection (n=18) or detachable balloon release (n=9) into the right main pulmonary artery. Four sheep were excluded after blood clot injection, as they did not exhibit adequate declines in blood oxygen saturation (SaO2). Nine of the sheep that received autologous blood clot and nine that received detachable balloons went on to treatment with right main bronchus occlusion. The control group (n=5) received the autologous blood clot, but no occlusion of the right main bronchus. All sheep underwent continuous monitoring of pulmonary arterial mean pressure (PAMP), SaO2, arterial partial pressure of oxygen (PaO2), and arterial partial pressure of carbon dioxide. RESULTS: Twenty-three sheep (85%) subjected to PE demonstrated immediate tachycardia, tachypnea, and decline in SaO2 of at least 25% within 30 min. After right main bronchus occlusion, 18 sheep (100%) survived for the length of the experiment and exhibited persistently higher SaO2 and PaO2 levels, as well as decreased PAMP compared with the controls. In the control group, two out of five sheep died within 30 min, and the three surviving subjects demonstrated significantly decreased SaO2 and PaO2 levels. CONCLUSION: Occlusion of the right main bronchus in an ovine model of massive PE effectively extends life and provides favorable physiological parameters to allow emergent interventions.

Original languageEnglish (US)
Pages (from-to)127-131
Number of pages5
JournalDiagnostic and Interventional Radiology
Volume18
Issue number1
DOIs
StatePublished - Jan 2012
Externally publishedYes

Fingerprint

Balloon Occlusion
Bronchi
Pulmonary Embolism
Sheep
Arterial Pressure
Thrombosis
Partial Pressure
Oxygen
Tachypnea
Lung
Control Groups
Injections
Patient Rights
Tachycardia
Carbon Dioxide
Pulmonary Artery
Hemodynamics
Mortality

Keywords

  • Animal experimentation
  • Balloon catheterization
  • Pulmonary embolism
  • Ventilation-perfusion ratio

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

Cite this

Balloon occlusion of the right main bronchus in an ovine model provides sufficient time for emergent interventions in massive pulmonary embolism. / Fan, Yong; Liu, Yang; Oklu, Rahmi; He, Neng Shu; li, Ping; Wu, Qi; Deipolyi, Amy; Wicky, Stephan; Song, Ho Young.

In: Diagnostic and Interventional Radiology, Vol. 18, No. 1, 01.2012, p. 127-131.

Research output: Contribution to journalArticle

Fan, Yong ; Liu, Yang ; Oklu, Rahmi ; He, Neng Shu ; li, Ping ; Wu, Qi ; Deipolyi, Amy ; Wicky, Stephan ; Song, Ho Young. / Balloon occlusion of the right main bronchus in an ovine model provides sufficient time for emergent interventions in massive pulmonary embolism. In: Diagnostic and Interventional Radiology. 2012 ; Vol. 18, No. 1. pp. 127-131.
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AU - li, Ping

AU - Wu, Qi

AU - Deipolyi, Amy

AU - Wicky, Stephan

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AB - PURPOSE: Massive pulmonary embolism (PE) causes hemodynamic compromise and is associated with a high rate of mortality. We sought to create a model of massive PE and to determine whether occlusion of the right main bronchus could mitigate the physiological effects of massive PE in this model. MATERIALS AND METHODS: We used 27 female sheep to generate a model of massive PE by either autologous blood clot injection (n=18) or detachable balloon release (n=9) into the right main pulmonary artery. Four sheep were excluded after blood clot injection, as they did not exhibit adequate declines in blood oxygen saturation (SaO2). Nine of the sheep that received autologous blood clot and nine that received detachable balloons went on to treatment with right main bronchus occlusion. The control group (n=5) received the autologous blood clot, but no occlusion of the right main bronchus. All sheep underwent continuous monitoring of pulmonary arterial mean pressure (PAMP), SaO2, arterial partial pressure of oxygen (PaO2), and arterial partial pressure of carbon dioxide. RESULTS: Twenty-three sheep (85%) subjected to PE demonstrated immediate tachycardia, tachypnea, and decline in SaO2 of at least 25% within 30 min. After right main bronchus occlusion, 18 sheep (100%) survived for the length of the experiment and exhibited persistently higher SaO2 and PaO2 levels, as well as decreased PAMP compared with the controls. In the control group, two out of five sheep died within 30 min, and the three surviving subjects demonstrated significantly decreased SaO2 and PaO2 levels. CONCLUSION: Occlusion of the right main bronchus in an ovine model of massive PE effectively extends life and provides favorable physiological parameters to allow emergent interventions.

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KW - Ventilation-perfusion ratio

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