{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2022,10,16]],"date-time":"2022-10-16T02:11:15Z","timestamp":1665886275202},"reference-count":9,"publisher":"Oxford University Press (OUP)","issue":"Supplement_1","funder":[{"name":"U. S. Air Force Surgeon General approved Clinical Investigation","award":["FDG20160027A"],"award-info":[{"award-number":["FDG20160027A"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,1,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>External cooling of ischemic limbs has been shown to have a significant protective benefit for durations up to 4 hours.<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and Methods<\/jats:title><jats:p>It was hypothesized that this benefit could be extended to 8\u00a0hours. Six swine were anesthetized and instrumented, then underwent a 25% total blood volume hemorrhage. Animals were randomized to hypothermia or normothermia followed by 8\u00a0hours of Zone 3 resuscitative endovascular balloon occlusion of the aorta, then resuscitation with shed blood, warming, and 3\u00a0hours of critical care. Physiologic parameters were continuously recorded, and laboratory specimens were obtained at regular intervals.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>There were no significant differences between groups at baseline. There were no significant differences between creatine kinase in the hypothermia group when compared to the normothermia group (median [IQR]\u00a0=\u00a015,206\u00a0U\/mL [12,476\u221219,987] vs 23,027\u00a0U\/mL [18,745\u221226,843]); P\u00a0=\u00a00.13) at the end of the study. Similarly, serum myoglobin was also not significantly different in the hypothermia group after 8\u00a0hours (7,345\u00a0ng\/mL [5,082\u221210,732] vs 5,126\u00a0ng\/mL [4,720\u22125,298]; P\u00a0=\u00a00.28). No histologic differences were observed in hind limb skeletal muscle.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>While external cooling during prolonged Zone 3 resuscitative endovascular balloon occlusion of the aorta appears to decrease ischemic muscle injury, this benefit appears to be time dependent. As the ischemic time approaches 8\u00a0hours, the benefit from hypothermia decreases.<\/jats:p><\/jats:sec>","DOI":"10.1093\/milmed\/usz306","type":"journal-article","created":{"date-parts":[[2020,2,19]],"date-time":"2020-02-19T20:12:00Z","timestamp":1582143120000},"page":"42-49","source":"Crossref","is-referenced-by-count":2,"title":["Effects of Extended Lower Extremity Cooling Following Zone 3 REBOA in a Porcine Hemorrhage Model"],"prefix":"10.1093","volume":"185","author":[{"given":"Harris W","family":"Kashtan","sequence":"first","affiliation":[{"name":"Clinical Investigation Facility, David Grant USAF Medical Center, 101 Bodin Cir, Travis Air Force Base, CA"},{"name":"Department of Surgery, University of California Davis Medical Center, 2221 Stockton Blvd, Sacramento, CA"},{"name":"Department of General Surgery, David Grant USAF Medical Center, 101 Bodin Cir, Travis Air Force Base, CA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Meryl A","family":"Simon","sequence":"first","affiliation":[{"name":"Clinical Investigation Facility, David Grant USAF Medical Center, 101 Bodin Cir, Travis Air Force Base, CA"},{"name":"Department of Surgery, University of California Davis Medical Center, 2221 Stockton Blvd, Sacramento, CA"},{"name":"Heart, Lung, and Vascular Center, David Grant USAF Medical Center, 101 Bodin Cir, Travis Air Force Base, CA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carl A","family":"Beyer","sequence":"first","affiliation":[{"name":"Clinical Investigation Facility, David Grant USAF Medical Center, 101 Bodin Cir, Travis Air Force Base, CA"},{"name":"Department of Surgery, University of California Davis Medical Center, 2221 Stockton Blvd, Sacramento, CA"},{"name":"Department of General Surgery, David Grant USAF Medical Center, 101 Bodin Cir, Travis Air Force Base, CA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew","family":"Wishy","sequence":"first","affiliation":[{"name":"Clinical Investigation Facility, David Grant USAF Medical Center, 101 Bodin Cir, Travis Air Force Base, CA"},{"name":"Department of Surgery, University of California Davis Medical Center, 2221 Stockton Blvd, Sacramento, CA"},{"name":"Heart, Lung, and Vascular Center, David Grant USAF Medical Center, 101 Bodin Cir, Travis Air Force Base, CA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Guillaume L","family":"Hoareau","sequence":"first","affiliation":[{"name":"Clinical Investigation Facility, David Grant USAF Medical Center, 101 Bodin Cir, Travis Air Force Base, CA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J Kevin","family":"Grayson","sequence":"first","affiliation":[{"name":"Clinical Investigation Facility, David Grant USAF Medical Center, 101 Bodin Cir, Travis Air Force Base, CA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M Austin","family":"Johnson","sequence":"first","affiliation":[{"name":"Clinical Investigation Facility, David Grant USAF Medical Center, 101 Bodin Cir, Travis Air Force Base, CA"},{"name":"Department of Emergency Medicine, University of California Davis Medical Center, 2315 Stockton Blvd, Sacramento, CA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2020,2,19]]},"reference":[{"issue":"3","key":"2020021912292701000_ref1","doi-asserted-by":"crossref","first-page":"512","DOI":"10.1097\/TA.0000000000001990","article-title":"Lower extremity cooling reduces ischemia-reperfusion injury following zone 3 REBOA in a porcine hemorrhage model","volume":"85","author":"Simon","year":"2018","journal-title":"J Trauma Acute Care 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