Development and Evaluation of New Products for the Far-Forward Care of Combat Casualties with Acute Lung Injury
Annual rept. 1 Feb 2005-31 Jan 2006
TRUE RESEARCH FOUNDATION SAN ANTONIO TX
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OBJECTIVE To evaluate the Intravenous Membrane Oxygenator or Hattler Catheter IMO in an ovine model of lung injury due to inhalation of chlorine gas. HYPOTHESIS IMO will improve the PaO2-to-FiO2 PFR ratio in injured sheep. METHODS Thirteen ewes sham IMO, n1 injury IMO, n7 injury without IMO, n5, were used. Anesthetized sheep were ventilated with 300 L of 100 ppm chlorine mixed in 100 O2. When animals reached ARDS PFR200, IMO was inserted in the injury IMO group. ICU care, deep sedation, and mechanical ventilation were continued for up to 96 h. RESULTS IMO was safely inserted in all cases. Gas exchange of the IMO was consistent at rates normalized to a PCO2 of 50 mmHg of 300-350 mlminm2. The IMO exerted a beneficial effect on PFR up to hour 18 and on PaCO2 up to hour 30. IMO use was associated with hemolysis, manifested by increased levels of plasma free hemoglobin. In order to reduce the anticipated impact of the HC on cardiac preload an aggressive approach to fluid management was employed, which likely worsened pulmonary edema and oxygenation. Thus, future studies employing the IMO will involve a fluid-sparing approach to management.
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