Extracorporeal Nerve Agent Detoxification: A Novel Approach Combining 2 High-Priority DOD Medical Programs for Battlefield Medicine
Abstract
Future multi-domain operations (MDO) against near-peer adversaries require new technologies and approaches to prolonged medical care of battlefield casualties. The development of field-deployable extracorporeal life support (ECLS) has been proposed to support single and multiorgan failure in combat applications, as well as ensure survivability at point of need and during en-route care. Recent events have shown that our near-peer adversaries are willing and able to deploy chemical warfare nerve agents (CWNAs). Current research to support prolonged protection against CWNAs utilizes bioscavengers, enzymes with the capacity to bind to or hydrolyze CWNAs, thereby rendering them harmless. While bioscavengers have proven effective at protecting against CWNA exposure in a laboratory setting, the regulatory and production pathway for non-immunogenic bioscavengers has proven difficult. The development of a field-deployable ECLS provides a novel platform for battlefield organ failure regardless of whether the injury is from trauma or CWNA exposure. In this context, ECLS can support respiration and cardiovascular function and, at the same time, serve as a platform for mitigation and treatment of CWNA intoxication. Removal of CWNAs from the blood through dialysis via ECLS and dialysate bioscavenging will reduce the CWNA exposure in addition to maintaining a steady level of protection during prolonged field care in a chemical environment. Since the bioscavenger will not enter the patients circulatory system, the circulatory stability, immunogenicity, and bioavailability limitations of the current bioscavenger approach are reduced or eliminated. As acute exposure to CWNAs can cause respiratory failure, ECLS is likely to be used to treat casualties that were also exposed to CWNAs, and adding a CWNA treatment to the system increases the probability of warfighter survival. Taken together, this proposal directly addresses the Combat Casualty Care Research Program Focus Area.
Document Details
- Document Type
- Technical Report
- Publication Date
- Aug 01, 2022
- Accession Number
- AD1214648
Entities
People
- Andriy I. Batchinsky
Organizations
- Geneva Foundation