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

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 Last 12 Months: 1
	More Statistics