Selective Aortic Arch Perfusion Technologies for Hemorrhage-induced Cardiac Arrest

Selective Aortic Arch Perfusion (SAAP) was invented by Manning specifically to treat both traumatic and non-traumatic/medical cardiac arrest. SAAP uses a descending aortic arch balloon occlusion catheter to selectively perfuse the heart and brain to restore intrinsic cardiac function and limit neurological injury. In hemorrhage-induced traumatic cardiac arrest (HiTCA), aortic occlusion controls subdiaphragmatic hemorrhage while SAAP with an exogenous oxygen-carrier (blood or hemoglobin solution) corrects hemorrhage-induced hypovolemia. If ROSC is not rapidly achieved, sequential SAAP modalities serve as a survival bridge to extracorporeal membrane oxygenation (ECMO). This project will develop advanced SAAP catheter and ECMO perfusion circuit technologies for (1) rapid, optimal SAAP therapy to effectively treat HiTCA and (2) sequential transition from SAAP modalities (including autologous blood-SAAP and limited/partial whole body ECMO) to full whole body veno-arterial ECMO. Optimized SAAP catheter designs will facilitate emergency insertion, accurate placement and effective SAAP therapy. SAAP-ECMO interface devices will promote easy transition through graded levels of SAAP-ECMO perfusion support. The therapeutic approach to HiTCA provided by these technologies could significantly improve survival rates from HiTCA which are presently dismal. These technologies will also become commercially available products for resuscitation of patients with HiTCA and non-traumatic cardiac arrest.