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Effects of Early Altitude Exposure Following Traumatic Injury and Hemorrhagic Shock

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Technical Report,01 Aug 2015,01 Apr 2017

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University of Cincinnati Cincinnati United States

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Hemorrhagic shock is the leading cause of potentially preventable death following traumatic injury. While damage control surgery and resuscitation techniques have revolutionized the care of injured soldiers who sustain severe traumatic hemorrhage, the physiologic consequences of hemostatic resuscitation and staged abdominal surgery in the face of early aeromedical evacuation AE are completely unknown. This study evaluated these two methods through use of a murine model of hemorrhagic shock with laparotomy and staged fascial closure, ultimately evaluating the effect of a simulated AE on these conditions. Following hemorrhage, resuscitation should commence as early as possible, prior to exposure to AE or staged abdominal surgery, to avoid prohibitive mortality. Following injury, immediate simulated AE resulted in increased acidosis as compared to delayed evacuation at 4 or 24 hours. Increased systemic inflammation occurs after transfusion of higher volumes of blood following hemorrhagic shock, with increased volume requirements occurring with the concomitant insult of simulated AE and staged abdominal closure. While the optimal resuscitation fluid is not definitively concluded, the inflammatory effects of blood transfusion may be detrimental as compared to Hextend in a controlled model of hemorrhage.

Subject Categories:

  • Medicine and Medical Research
  • Escape, Rescue and Survival

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