Far forward gaps in hemorrhagic shock and prolonged field care: an update of ALM fluid therapy for field use

Dobson, Geoffrey P., and Letson, Hayley L. (2020) Far forward gaps in hemorrhagic shock and prolonged field care: an update of ALM fluid therapy for field use. Journal of Special Operations Medicine, 20 (3). pp. 128-134.

PDF (Published Version) - Published Version
Restricted to Repository staff only

View at Publisher Website: https://www.jsomonline.org

Abstract

Future expeditionary missions are expected to occur in more remote austere environments where combat medics and casualties may have to wait up to 7 days before resupply or safe evacuation. Currently, there is no effective fluid therapy for hemorrhagic shock (HS) at the point-of-injury and continuum-of-care over this extended period. We have been developing a small-volume IV or IO ALM therapy for noncompressible HS and have shown in preclinical models that it extends survival to 3 days, reduces abdominal bleeding by 60%, blunts inflammation, corrects coagulopathy, preserves platelet function, and prevents immunodeficiency. The ALM-survival phenotype is associated with an upregulation of the master genes of metabolism and mitochrondrial biogenesis in heart and brain and a downregulation in the periphery. Future translational studies will investigate the timing and nature of the "switch" and extend survival to 7 days. We will also discuss some of the controversies of ALM resuscitation in pigs, present our Systems Hypothesis of Trauma (SHOT), and discuss future clinical safety trials before field use.


Item ID:	64530
Item Type:	Article (Research - C1)
ISSN:	1553-9768
Keywords:	hemorrhage; trauma; survival; genetics; metabolism; inflammation; military medicine; resuscitation
Related URLs:	Publisher
Funders:	USSOCOM
Projects and Grants:	W81XWH-USSOCOM-BAA-15-1
Date Deposited:	06 Oct 2020 02:22
FoR Codes:	32 BIOMEDICAL AND CLINICAL SCIENCES > 3201 Cardiovascular medicine and haematology > 320199 Cardiovascular medicine and haematology not elsewhere classified @ 50% 32 BIOMEDICAL AND CLINICAL SCIENCES > 3202 Clinical sciences > 320207 Emergency medicine @ 50%
SEO Codes:	92 HEALTH > 9201 Clinical Health (Organs, Diseases and Abnormal Conditions) > 920103 Cardiovascular System and Diseases @ 50% 92 HEALTH > 9201 Clinical Health (Organs, Diseases and Abnormal Conditions) > 920199 Clinical Health (Organs, Diseases and Abnormal Conditions) not elsewhere classified @ 50%
Downloads:	Total: 3
	More Statistics

Actions (Repository Staff Only)

Item Control Page