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Conservation of Battlefield Blood Supply

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Final rept. 1 Nov 94-31 Oct 96

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In a battlefield environment, it is likely that blood will be in short supply. The logistic problem of providing timely supply of blood to the battlefield and distributing that blood to needed locations will likely keep the supply of blood at levels substantially less than demand. Conservation of this vital resource will be essential. An important part of that conservation is limitation of use of this resource to only when absolutely essential. Accordingly, we attempted to define the human limitation for acute isovolemic anemia i.e. the transfusion trigger, the point at which oxygen transport becomes inadequate and transfusion becomes imperative. The research effort was greatly limited as a result of unanticipated truncation in time and funding from the originally approved 3 years to 1 year, with one-third the resources. We studied conscious, unmedicated humans, acutely lowering their blood hemoglobin concentration from normal to 5 gdL, while maintaining normovolemia. Heart rate, stroke volume and cardiac index increased, systemic vascular resistance and oxygen content and transport decreased. However indicators of adequate tissue oxygen supply, oxygen consumption and blood lactate concentration did not change. Nor did electrocardiographic monitoring Holter indicate the presence of myocardial ischemia. Because we were only able to study 22 rather than the originally proposed and approved 60 people, statistical conclusions from our data are limited our data indicates that not more than 14 of the normal population would be expected to have inadequate oxygen delivery when hemoglobin concentration is acutely and isovolemically decreased to 5gdL.

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  • Anatomy and Physiology
  • Medicine and Medical Research

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