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Temporary arterial shunts to maintain limb perfusion after arterial injury: an animal studyBACKGROUND: Temporary shunt placement can quickly restore perfusion after extremity arterial injury. This study examined the adequacy of limb blood flow with shunt use, non-heparin-bonded shunt patency over prolonged periods, and the safety of this technique. METHODS: Common iliac arteries were divided and 4.0-mm Silastic Sundt shunts placed in 16 anesthetized pigs. Eight (group I) had shunts placed immediately; eight others (group II) were shunted after an hour of limb ischemia and hemorrhagic shock. Physiologic parameters and femoral artery blood flow in both hindlimbs were continuously monitored. Limb lactic acid generation, oxygen utilization, and hematologic and metabolic effects were serially evaluated for 24 hours. RESULTS: Shunts remained patent in 13 of 16 pigs. Shunts thrombosed in two group I animals because of technical errors, but functioned well after thrombectomy and repositioning. Patency could not be maintained in one animal that died from shock. Flow in group I shunted limbs was 57 (+/-11 SD) % of control. For group II animals in shock, shunted limb flow initially averaged 46 +/- 15% of control, but 4 hours after shunt placement, the mean limb blood flow was the same as in group I. Increased oxygen extraction compensated for the lower flow. Lactic acid production was not increased in comparison to control limbs. CONCLUSION: Shunts provided adequate flow in this model of extremity trauma. Correctly placed shunts stayed patent for 24 hours, without anticoagulation, if shunt placement followed resuscitation.
Document ID
20040141884
Acquisition Source
Legacy CDMS
Document Type
Reprint (Version printed in journal)
Authors
Dawson, D. L.
(Wilford Hall Medical Center Lackland AFB, Texas, United States)
Putnam, A. T.
Light, J. T.
Ihnat, D. M.
Kissinger, D. P.
Rasmussen, T. E.
Bradley, D. V. Jr
Date Acquired
August 22, 2013
Publication Date
July 1, 1999
Publication Information
Publication: The Journal of trauma
Volume: 47
Issue: 1
ISSN: 0022-5282
Subject Category
Life Sciences (General)
Distribution Limits
Public
Copyright
Other

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