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Critically wounded soliders are quickly moved to a field hospital. UC researchers are studying how rapid movement and altitude changes associated with air medical evacuation may impact survival.

Critically wounded soliders are quickly moved to a field hospital. UC researchers are studying how rapid movement and altitude changes associated with air medical evacuation may impact survival.
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Publish Date: 08/26/09
Media Contact: Katy Cosse, 513-556-2635
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UC Researchers Focus on Critical Care Needs of Injured Troops

CINCINNATIóResearchers from the University of Cincinnati (UC) department of surgery, division of trauma, will present their research on the most pressing issues facing military medical teams at this year's Air Force Medical Service (AFMS) Research Symposium, held in Washington, D.C., Aug. 25-27.

The research, funded by the Air Force, concentrates on issues surrounding the critical care transport of injured troops, including studies on the effects of altitude on traumatic brain injury, inflammation after burn wounds, the delivery of oxygen after injury and resuscitation using stored blood products.

"The research that we are doing is hitting at the heart of what the Air Force is doing," says Alex Lentsch, PhD, director of UC's surgical research unit.

Lentsch will travel to the conference along with five other UC researchers, representing research done at UC and at the Center for Sustainment of Trauma and Readiness Skills (C-STARS) at University Hospital. Those presenting include trauma and critical care chief Jay Johannigman, MD, associate professor of surgery Richard Branson, MSc, trauma and critical care surgeon Timothy Pritts, MD, and surgical residents Mike Goodman, MD, and Amy Makley, MD.

"The common thing that weíre focused on is critical care transport," says Pritts. "Thatís really where all this stuff starts. The question is: 'How can you care for wounded soldiers or airmen or sailors better while they are being transported?' "

Goodman will present results from a year-long study of the effect of altitude on neuroinflammation after traumatic brain injury. Goodman and the UC team spent a year on the study, using an altitude chamber at the Brooks City-Base in San Antonio, Texas.

Looking at a model of traumatic brain injury, Pritts said they found early exposure to altitude after the injury worsened the neuroinflammatory response.

"It also increased the release of some markers of brain injury into the blood, suggesting that it was worsening the injury," he says. Researchers found the markers increased threefold in models exposed to altitude several hours after an injury, as compared to models exposed to altitude 24 hours after injury.

Though the research cannot be extrapolated to people, Pritts says it provides information that could further research into a possible ideal time to transport injured troops.

Makley will present the findings from a study on the effects of transfusing "newer" versus "older" blood products in patients with hemorrhagic shock, in which a patient has bled a significant amount of blood volume after a car accident or similar injury.

Lentsch says the research is relevant both to civilian and military populations, but especially key for treating injuries in the theater of combat, where blood stores are typically much older than most civilian stores.

Particularly notable is the way in which Makley carried out the study.

"As far as we know, she's developed the first mouse blood bank," says Lentsch. "It sounds kind of silly, but up to this point, there was no blood bank for that, so you really couldn't study the type of things that this has allowed her to study."

Other UC researchers are focusing on how military medical personnel carry and deliver oxygen to patients. Johannigman and Branson are presenting work by C-STARS Senior Master Sgt. Dario Rodriguez, RRT.

"One of the major problems the Air Force has right now is transporting oxygen canisters," says Pritts, "because wherever you go, you have to make or bring your own oxygen with you."

Rodriguez has conducted a series of studies looking at a portable device able to concentrate oxygen more than current storage canisters.

Johannigman and Branson will present a ventilator software package they created to better track patients' blood oxygen levels. Pritts says the software is designed to precisely measure how much oxygen a patient needs, then distribute exactly thatóavoiding wasting any oxygen in the process.

"It senses levels every minute and responds," he says. "If it senses a blip, it spikes your oxygen inflow back up and keeps it there. Then it can bring it back down and it can do it faster than any team we've seen. It's really neat stuff."

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