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Simulated Aeromedical Evacuation in a Polytrauma Rat Model.

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    Aeromedical evacuation impacts physiological parameters in injured rats, with low blood pressure and oxygen levels significantly increasing mortality risk during simulated transport.

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    Area of Science:

    • Physiology
    • Trauma Medicine
    • Aerospace Medicine

    Background:

    • Hemorrhage and traumatic brain injury are life-threatening conditions.
    • Aeromedical evacuation (AE) of severely wounded combat casualties can lead to complications, especially in mass casualty or prolonged field care scenarios.
    • Limited resources during prolonged field care necessitate understanding AE's impact on critical patients.

    Purpose of the Study:

    • To investigate the physiological effects of simulated aeromedical evacuation on rats subjected to blast injury and hemorrhage.
    • To determine the impact of simulated altitude (hypobaria) versus sea-level conditions on survival and physiological parameters during AE.
    • To identify critical factors influencing survival in injured animals during simulated AE.

    Main Methods:

    • Anesthetized Sprague-Dawley rats underwent blast injury and controlled hemorrhage.
    • Rats were resuscitated with saline and subjected to a simulated 3-hour AE at 8000 ft (hypobaria) or sea-level (normobaria).
    • Physiological parameters (heart rate, temperature, oxygenation) were continuously recorded; hematology and metabolic levels were measured.

    Main Results:

    • Survival rates were 100% in controls, 83% in injured under normobaria, and significantly reduced to 50% under hypobaria.
    • Hypobaria led to significantly lower hemodynamics, thermoregulation, and oxygenation compared to normobaria.
    • Lower mean arterial pressure (MAP) and reduced oxygen levels prior to AE were critical for injured animal survival.

    Conclusions:

    • Aeromedical evacuation significantly affects physiological parameters in all rats, with injured animals experiencing worsened outcomes.
    • Injured animals with MAP < 60 mmHg and low oxygen saturation (SpO₂) during simulated AE faced a high mortality risk.
    • Findings highlight the risks associated with AE for severely polytraumatized patients, particularly under hypobaric conditions.