Defining the Systemic Response to Flight After Polytrauma in a Murine Model

Area of Science:

• Aeromedical evacuation
• Trauma research
• Hypobaric physiology

Background:

• Aeromedical evacuation is expanding, necessitating research into its effects on trauma patients.
• The hypobaric and hypoxic environment of flight can negatively impact injury outcomes.
• No studies have examined the effects of flight after polytrauma.

Purpose of the Study:

• To investigate the effects of simulated flight on polytrauma in mice.
• To determine if hypobaric hypoxia exacerbates inflammation, endotheliopathy, and coagulopathy post-polytrauma.

Main Methods:

• Mice underwent a polytrauma model (laparotomy, crush injury, splenectomy, shock).
• Polytrauma mice were exposed to simulated flight (1 hour at 12,000 feet).
• Analyzed serum cytokines, endotheliopathy markers, lung histology, and coagulation profiles.

Main Results:

• Flight combined with polytrauma elevated systemic proinflammatory cytokines (IL-1β, MCP-1, MIP-1α, TNFα).
• Interleukin-1 alpha (IL-1α) was uniquely increased in polytrauma with flight.
• Coagulopathy and endotheliopathy markers were not worsened by flight post-polytrauma.

Conclusions:

• Early altitude exposure post-polytrauma has an additive effect on inflammation, potentially identifiable by IL-1α.
• Flight did not exacerbate trauma-induced coagulopathy or endotheliopathy in this murine model.
• Further research is needed to understand the physiological basis for worsened clinical outcomes after early post-injury aeromedical evacuation.