Evaluation of Neurophysiologic and Systematic Changes during Aeromedical Evacuation and en Route Care of Combat Casualties in a Swine Polytrauma
Annual rept. 15 Jan 2014 - 14 Jan 2015
HENRY M JACKSON FOUNDATION FOR THE ADVANCEMENT OF MILITARY MEDICINE BETHESDA MD
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There is a dearth of knowledge about the effects of long range aero-medical evacuation on injured organs, as well as an emerging published database suggesting clinically significant adverse effects of hypobaria on even healthy tissues. Cabin pressure is equivalent to an altitude around 8,000ft. at which inspired oxygen is sufficient to maintain blood oxygen saturation above 90 in a healthy individual. In combat casualties with multiple injuries this could however compromise oxygen delivery and result in hypoxemia. Additionally, increase in altitude with concomitant decrease in atmospheric pressure allows gas expansion in body cavities. The volume of trapped gas expands by approximately 35 from sea level to an altitude of 8,000 feet. This can expose already vulnerable patients to severe complications. In light of this, a thorough investigation of the effects of hypobaria in clinical settings simulating the most important injury patterns encountered by combat casualties is necessary to optimize treatment efficacy and safety. During the second year of this project, pilot experiments to test the hypobaric chamber in a live, anesthetized animal have been completed. Unexpected issues with animal temperature control, anesthesia delivery, and Total Intravenous anesthesia have been resolved. Animals experiment sunder normobaric and hypobaric conditions have been initiated. The NMRC Center for Hypobaric Experimentation, Simulation and Testing CHEST provides a unique platform for evaluation of long-range evacuation effects on physiology and therapeutic interventions in military relevant large animal combat injury models, which may contribute to optimization of combat casualty care and evacuation guidelines.
- Medicine and Medical Research
- Escape, Rescue and Survival