Research on the efficacy and reliability of manual pressure on abdominal aorta during pelvic and lower extremity bleeding

İntroduction: Penetrating junctional trauma is a leading cause of preventable death on the battlefield. Similarly challenging in civilian settings, exsanguination from the vessels of the abdomen, pelvis and groin can occur in moments. Therefore prehospital iliac artery or abdominal aortic compression has been recommended. Purpose: Evaluating the safety and efficacy of decreasing blood flow from the abdominal aorta with external compression of the abdominal aorta. Material and Methods: 15, 30 and 45 minutes of external compression of the abdominal aorta treatments have been compared to investigate their effects on renal, mesenteric and intestinal ischemia and serum ALT, AST,urine, creatinine, Na, K ve lactic asid levels. A total of 18 female Sprague-Dawley rats weighing 245-300 grams were used for this study, 2 of which were used for pilot study. Rats were divided in 4 groups consisting of 4 animals. In the first group no intervention was performed as they served as the control group. While 15 minutes of compression was applied on the second group, 30 minutes of compression was applied on the third group and 45 minutes of compression was applied on the fourth group. Blood flow from the abdominal aorta was measured in all groups. After the intervention, blood samples were taken to determine serum ALT, AST,urine, creatinine, Na, K ve lactic asid levels. İntestinal, renal and mesenteric tissue samples were taken for histopathological analysis. Results: There was a significant decrease in blood flow from the abdominal aorta with external compression in each subject. Serum potassium and lactic acid levels increased after the compression but these changes were not statistically significant. Gross and histological examination revealed signs of ischemia of the tissue samples after the compression and more changes were seen as the compression time increases. Conclusion: Abdominal aortic compression was effective at reducing flow in the abdominal aorta and ceased flow in all of the subjects. Compression didn't cause a statistically significant change in serum Na, K, ALT, AST, urine, creatinine ve lactic acid levels. Signs of ischemia of the renal, mesenteric and intestinal tissue samples were seen after the compression. Futher studies are needed to evaluate the safe upper time limit for irreversible ischemia. Abdominal aortic compression is an effective way to control junctional hemorrhage but futher tests on human subjects with junctional hemorrhage are needed.