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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
Summary
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.
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.
