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Simulated Aeromedical Evacuation Exacerbates Experimental Brain Injury.

Jacob W Skovira1, Shruti V Kabadi1, Junfang Wu1

  • 11 Department of Anesthesiology, Center for Shock, Trauma and Anesthesiology Research (STAR), University of Maryland School of Medicine , Baltimore, Maryland.

Journal of Neurotrauma
|November 24, 2015
PubMed
Summary
This summary is machine-generated.

Aeromedical evacuation involving hypobaria worsens traumatic brain injury (TBI) outcomes. Prolonged low-pressure exposure after TBI impairs cognitive function and increases neuroinflammation, with hyperoxia and repeated exposures worsening effects.

Keywords:
aeromedical evacuationhypobariainflammationneuronal cell deathtraumatic brain injury

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Area of Science:

  • Neuroscience
  • Trauma Research
  • Aerospace Medicine

Background:

  • Aeromedical evacuation is crucial for TBI patients, especially in combat zones.
  • Exposure to hypobaria during evacuation may impact TBI pathophysiology and outcomes.
  • Previous research on hypobaria's effects post-TBI is limited.

Purpose of the Study:

  • To investigate the impact of prolonged hypobaric exposure on behavioral and histological outcomes in a rat model of TBI.
  • To determine if hypobaria at different time points after TBI exacerbates neurological deficits.
  • To assess the effects of hyperoxia and repeated hypobaric exposures on TBI recovery.

Main Methods:

  • Adult male Sprague-Dawley rats received fluid percussion TBI.
  • Rats were exposed to hypobaric conditions (0.75 atm) for 6-10 hours at various times post-injury (6h, 24h, 72h, 7 days).
  • Evaluations included sensorimotor and cognitive tests, histological analysis of the hippocampus, and assessment of neuroinflammation (microglial/astrocyte activation).

Main Results:

  • Hypobaric exposure up to 7 days post-TBI significantly worsened cognitive deficits.
  • Increased hippocampal neuronal loss and microglial/astrocyte activation were observed in hypobaric-exposed rats.
  • Hyperoxia during exposure or multiple hypobaric exposures further exacerbated spatial memory deficits and neuroinflammation.

Conclusions:

  • Prolonged hypobaria following TBI impairs long-term cognitive function and increases neuroinflammation, even with physiological oxygen levels.
  • Repeated hypobaric exposures or the use of 100% oxygen during evacuation worsen these adverse effects.
  • Findings highlight the potential risks of aeromedical evacuation for TBI patients and suggest further research into mitigation strategies.