Development and Evaluation of New Products for the Far-Forward Care of Combat Casualties with Acute Lung Injury
Abstract
OBJECTIVE: To evaluate the Intravenous Membrane Oxygenator or Hattler Catheter (IMO) in an ovine model of lung injury due to inhalation of chlorine gas. HYPOTHESIS: IMO will improve the PaO2-to-FiO2 (PFR) ratio in injured sheep. METHODS: Thirteen ewes (sham + IMO, n=1; injury + IMO, n=7; injury without IMO, n=5,) were used. Anesthetized sheep were ventilated with 300 L of 100 ppm chlorine (mixed in 100% O2). When animals reached ARDS (PFR<200), IMO was inserted in the injury + IMO group. ICU care, deep sedation, and mechanical ventilation were continued for up to 96 h. RESULTS: IMO was safely inserted in all cases. Gas exchange of the IMO was consistent at rates (normalized to a PCO2 of 50 mmHg) of 300-350 ml/min/m2. The IMO exerted a beneficial effect on PFR up to hour 18 and on PaCO2 up to hour 30. IMO use was associated with hemolysis, manifested by increased levels of plasma free hemoglobin. In order to reduce the anticipated impact of the HC on cardiac preload an aggressive approach to fluid management was employed, which likely worsened pulmonary edema and oxygenation. Thus, future studies employing the IMO will involve a fluid-sparing approach to management.
Document Details
- Document Type
- Technical Report
- Publication Date
- Feb 01, 2006
- Accession Number
- ADA458205
Entities
People
- Andriy I. Batchinsky
- Brack Hattler
- Leopoldo C. Cancio