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HAPPENINGS

September 7, 2017 – From the Battlefield to Bedside: Expanding the use of endovascular resuscitation devices to optimize the care of the critically ill and wounded

Advances in endovascular technology over the last 20 years have allowed for small minimally invasive devices to be used during the early care of patients dying from hemorrhage. Although first described in the Korean Conflict, inflating balloon-tipped catheters in blood vessels to block blood flow to control bleeding did not become commonplace until the last 10 years as U.S. Military vascular surgeons cared for wounded soldiers in Iraq and Afghanistan. The vascular surgery technical revolution of the 1990’s set the stage for the emerging concept of Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA). REBOA is a trauma resuscitation maneuver in which a balloon catheter to occlude the body’s main artery can stop the flow of blood to the abdomen and pelvis thereby decreasing ongoing hemorrhage to stabilize a patient long enough for transfer to surgery.

Although REBOA can save lives, it has serious consequences and can only be used for brief periods of time. Occluding the aorta limits blood flow to the spinal cord, kidneys, and bowels causing profound ischemia which rapid leads to multi-organ failure. These serious side effects have prevented the widespread adoption of REBOA. Therefore, new methods and devices for endovascular bleeding control must be developed so that more patients might benefit from these potentially lifesaving interventions.

While aortic occlusive technologies were first developed for hemorrhage control, the ability to compartmentalize blood flow throughout the body has provided new opportunities for the resuscitation of patients suffering from multiple etiologies of shock. Understanding the tolerable thresholds of ischemia of different vital organs in different shock states while creating new technologies that allow titratable volumes of flow will allow providers to harness the power of endovascular resuscitation for a greater number of patients.

Dr. Austin Johnson and his collaborators have developed novel methods to extend the total duration of aortic occlusion technology. Through their work, new concepts for the resuscitation of critically ill and injured patients have been developed. While some of these new concepts have already been successfully used to save lives, other concepts require the development of advanced technology to fully realize the potential of endovascular resuscitation. Please join us in listening to Dr. Johnson discuss the future of resuscitation, and the historical perspective of one of the most exciting recent technological revolutions in trauma and critical care medicine.

About the Speaker

Austin Johnson, MD, PhD is an assistant professor of Emergency Medicine at UC Davis Medical Center and a co-founder of 3Ci, a biomedical device company based in Sacramento. Dr. Johnson is a practicing emergency medicine physician as well as the principal investigator of a DoD-funded laboratory. He has a PhD in neuroscience with an expertise in tissue engineering and electrophysiology. Besides developing novel devices and techniques for endovascular resuscitation, Dr. Johnson has developed biomedical devices to optimize ventilation for critically ill patients as well as novel critical care platforms capable of providing care autonomously in resource and provider constrained settings.

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