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A New Ultra-Small Volume Fluid for Far-Forward, Non-Compressible Hemorrhage and Traumatic Brain Injury

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Technical Report,01 Nov 2014,31 Oct 2015

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JAMES COOK UNIVERSITY Townsville, Queensland Australia

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Noncompressible truncal hemorrhage is the leading cause of potentially survivable trauma in far-forward combat environments, and no effective therapy exists. Hemorrhage combined with traumatic brain injury TBI is particularly lethal. Our aim was to examine the effect of small-volume 3 NaCl adenosine, lidocaine and Mg2 ALM bolus and 0.9 NaCl ALM drip 3-4 hour on resuscitation, cardiac function, hemostasis and survivablity in three rat models of 1 hepatic hemorrhage 60 resection and shock, 2 mild-to-moderate TBI, and 3 combined TBI and hepatic hemorrhage. In the first model, ALM therapy reduced uncontrolled blood loss by up to 60 and improved blood flow to the gut and kidney, and Hextend administered according to TCCC guidelines promoted internal bleeding, organ failure and early death. ALMs ability to significantly reduce blood loss may arise from its unique ability to improve cardiac function, correct coagulopathy, blunt systemic inflammation and improve tissue oxygenation. In the second study, ALM treatment protected against secondary brain injury and improved cardiac function following TBI, and in the third lethal model of TBI and hemorrhage, ALM therapy resulted in 50 survivability and 50 less internal blood loss compared to 100 mortality in 3 NaCl controls. Small-volume ALM fluid therapy may have wide applications for SOF medicscorpsman to improve warfighter survivability in far-forward environments.

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