Related Experiment Video
Updated: Apr 28, 2026
Author Spotlight: Using Point-of-Care Ultrasound for Comprehensive Evaluation of the Abdominal Aorta
Published on: September 8, 2023
Point-of-care ultrasound-guided external aortic compression compared to manual external aortic compression: a
Ann-Sophie Turcotte1,2, Alexis Cournoyer1,3,2,4, Jean Paquet3
1Université de Montréal, Montréal, Québec, Canada.
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.
