Mechanical Tissue Resuscitation at the Site of Traumatic Brain Injuries Reduces the Volume of Injury and Hemorrhage in a Swine Model

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