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Objectives <p>External compression of the abdominal aorta is a promising bridging therapy to reduce bleeding at non-compressible sites in trauma patients with hemorrhagic shock. This study aimed to evaluate femoral arterial flow reduction and pain associated with ultrasound-guided versus blind manual aortic-compression, performed by a low-weight versus medium-weight clinician.</p> Methods <p>We conducted a crossover experimental study on healthy volunteers. Ultrasound-guided and manual aortic-compression were performed by two physicians (80&#xa0;kg and 54&#xa0;kg). The primary outcome—originally defined as the difference in femoral blood flow reduction measured by Doppler—was modified early in data collection to the proportion of participants with complete flow occlusion, as this was found to be a more objective and physiologically relevant measure. Mixed models with two repeated measures compared complete occlusion between techniques and operator weights (alpha = 0.05). Pain scores and adverse effects at 0, 24&#xa0;hour, and 7&#xa0;days were also measured.</p> Results <p>The study was stopped after 20 volunteers underwent compression (mean BMI: 22; female: 65%) due to significant pain and two vasovagal syncopal episodes. Complete femoral flow occlusion was achieved using either technique in 19 (95%) and 17 (85%) participants for the 80-kg and 54-kg operators, respectively. No significant effect of technique was observed (p = 0.54). A trend toward an operator effect (greater effectiveness for the 80-kg operator; p = 0.07) was noted, with no interaction between operator weight and technique (p = 1.0).</p> Conclusion <p>This exploratory study on healthy volunteers suggests that both ultrasound-guided and manual external aortic-compression can achieve complete femoral arterial occlusion in most participants but cause significant pain and adverse events. Although the clinical implications remain uncertain, the procedure could be considered as a temporary, last resort measure for temporizing patients with severe, uncontrolled hemorrhagic shock.</p> Registered at clinical.gov <p>NCT04745585.</p>

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Point-of-care ultrasound-guided external aortic compression compared to manual external aortic compression: a prospective crossover trial on healthy volunteers

  • 期刊论文

  • 发表日期：

    2026年4月27日

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  • Ann-Sophie Turcotte,
  • Alexis Cournoyer,
  • Jean Paquet,
  • Éric Piette,
  • Nancy Zhu,
  • William Bédard Michel,
  • Laurent Bilodeau,
  • Raoul Daoust

摘要

Objectives

External compression of the abdominal aorta is a promising bridging therapy to reduce bleeding at non-compressible sites in trauma patients with hemorrhagic shock. This study aimed to evaluate femoral arterial flow reduction and pain associated with ultrasound-guided versus blind manual aortic-compression, performed by a low-weight versus medium-weight clinician.

Methods

We conducted a crossover experimental study on healthy volunteers. Ultrasound-guided and manual aortic-compression were performed by two physicians (80 kg and 54 kg). The primary outcome—originally defined as the difference in femoral blood flow reduction measured by Doppler—was modified early in data collection to the proportion of participants with complete flow occlusion, as this was found to be a more objective and physiologically relevant measure. Mixed models with two repeated measures compared complete occlusion between techniques and operator weights (alpha = 0.05). Pain scores and adverse effects at 0, 24 hour, and 7 days were also measured.

Results

The study was stopped after 20 volunteers underwent compression (mean BMI: 22; female: 65%) due to significant pain and two vasovagal syncopal episodes. Complete femoral flow occlusion was achieved using either technique in 19 (95%) and 17 (85%) participants for the 80-kg and 54-kg operators, respectively. No significant effect of technique was observed (p = 0.54). A trend toward an operator effect (greater effectiveness for the 80-kg operator; p = 0.07) was noted, with no interaction between operator weight and technique (p = 1.0).

Conclusion

This exploratory study on healthy volunteers suggests that both ultrasound-guided and manual external aortic-compression can achieve complete femoral arterial occlusion in most participants but cause significant pain and adverse events. Although the clinical implications remain uncertain, the procedure could be considered as a temporary, last resort measure for temporizing patients with severe, uncontrolled hemorrhagic shock.

Registered at clinical.gov

NCT04745585.