Citation

Zheng ZL, Morykwas M, Campbell D, McGee M, Hollingsworth C, Adams F, Mays J, Tatter S, Argenta L. Neurosurgery 2014; 75(2): 152-62; discussion 161-2.

Affiliation

1Department of Plastic and Reconstructive Surgery, 2Department of General Surgery, 3Department of Neurosurgery, Wake Forest University Health Sciences, Winston-Salem, North Carolina, USA.

Copyright

(Copyright © 2014, Congress of Neurological Surgeons)

DOI

10.1227/NEU.0000000000000341

PMID

24618796

Abstract

BACKGROUND:: Traumatic brain injuries (TBI) continue to be a devastating problem with limited treatment options. Previous research applying controlled vacuum to TBI in a rat model resulted in smaller injuries and more rapid recovery. OBJECTIVE:: To examine the effects of application of controlled vacuum (mechanical tissue resuscitation) to TBI in a large animal model. Magnitude of vacuum, length of application, and length of delay between injury and application of mechanical tissue resuscitation were investigated. METHODS:: Localized, controlled cortical injuries (CCI) were created in swine. Vacuums of -50 and -100 mm Hg were compared. Mechanical tissue resuscitation for 3 or 5 days was compared. Delays of 0, 3, or 6 hours between creation of the TBI and initiation of mechanical tissue resuscitation were examined. Analysis included histological assessments, CT perfusion, and MR imaging (T2, proton-magnetic spectra). RESULTS:-: 100 mm Hg vacuum resulted in significantly smaller mean contused brain and hemorrhage volumes compared with -50 mm Hg and controls. MR spectra of treated animals returned to near baseline values. All 10 animals with 5-day mechanical tissue resuscitation treatment survived. Three of 6 animals treated 3 days died after discontinuation of treatment. A 3-hour delay resulted in similar results as immediate treatment. A 6-hour delay produced significant, but lesser responses. CONCLUSION:: Application of mechanical tissue resuscitation to TBI was efficacious in the large animal model. Application of -100 mm Hg for 5 days resulted in significantly improved outcomes. Delays of up to 3 hours between injury and initiation of treatment did not diminish efficacy of the mechanical tissue resuscitation treatment.

Language: en