Computational study of haemodynamic change induced by the resuscitative endovascular balloon aortic occlusion

ABSTRACT

Resusciative endovascular balloon aortic occlusion (REBOA) can be used in various surgical operations, especially in patients with hypotension and shock caused by traumatic main vascular rupture and massive haemorrhage. However, the hydrodynamic effects of surgery on aortic haemodynamics and organ perfusion are still unclear. Herein, computational fluid dynamic methods were used to evaluate the effect of balloon expansion and that of balloon-occluded aortic ratios on haemodynamics. The simulation shows that the balloon reduces the flow rate from the heart to the ruptured aorta. While reducing the flow rate of the aortic branches downstream of the balloon under conditions with fixed cardiac output, the balloon will increase the flow rate of the aortic branches upstream of the balloon. And the flow in the diastolic phase is more complicated than that of the systolic phase, and the vortex generated upstream of the balloon is more evident than that of the formed downstream. Moreover, when the inflation rate of the balloon changes rapidly, the flow rate of blood at the balloon changes suddenly accordingly, which generates a large additional pressure on the balloon. The pressure will spread upstream, thereby generating a blood hammer effect on the blood vessel wall.

KEYWORDS:

• REBOA
• balloon inflation
• haemodynamics
• aorta with different occlusion degrees

Disclosure statement

No potential conflict of interest was reported by the author(s).

Authors’ contributions

Jiade Qiu: Conceived the study, performed data analysis, prepared the figures, and wrote the manuscript; Xiaomei Tian: Designed the study, prepared the figures, performed data analysis, and revised the manuscript; Hongjun Yuan: Technical support, data analysis, and revised the manuscript; Junyang Cao and Xin Li: Revised the manuscript; Dengfeng Wu: Technical support, critical feedback, data analysis and revised the manuscript; Daojian Cheng: Critical feedback; Xianren Zhang: Revised the manuscript; Fengyong Liu: Technical support, critical feedback, data analysis and revised the manuscript.

Additional information

Funding

This work was funded by grants from the National Natural Science Foundation of China (No. 81671800).