Closing the 'care in the air' capability gap for severe lung injury: the Landstuhl Acute Lung Rescue Team and extracorporeal lung support
| Autor: | Clayne Benson, Morris T. Porter, Johana Sierra-Nunez, John S. Oh, Gina R. Dorlac, Sandra M. Wanek, Shannon G. Womble, Raymond Fang, Erik Osborn, Stephen V. Silvey, Patrick F. Allan, Richard S. Russ, Warren C. Dorlac |
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| Rok vydání: | 2011 |
| Předmět: |
Emergency Medical Services
medicine.medical_treatment Acute Lung Injury Lung injury Critical Care and Intensive Care Medicine Hospitals Military Extracorporeal Military medicine Extracorporeal Membrane Oxygenation Germany Extracorporeal membrane oxygenation Emergency medical services Medicine Humans Military Medicine Iraq War 2003-2011 Lung Afghan Campaign 2001 business.industry Critically ill High-frequency ventilation medicine.disease medicine.anatomical_structure Transportation of Patients Surgery Medical emergency business |
| Zdroj: | The Journal of trauma. 71 |
| ISSN: | 1529-8809 |
| Popis: | The success of US Air Force Critical Care Air Transport Teams (CCATT) in transporting critically ill and injured patients enabled changes in military medical force deployment and casualty care practice. Even so, a subset of casualties remains who exceed even CCATT capabilities for movement. These patients led to the creation of the Landstuhl Acute Lung Rescue Team (ALeRT) to close the "care in the air" capability gap.The ALeRT Registry was queried for the period between November 1, 2005, and June 30, 2010. Additionally, Landstuhl Regional Medical Center critical care patient transfers to host nation medical centers were reviewed for cases using extracorporeal lung support systems.For the review period, US Central Command activated the ALeRT on 40 occasions. The ALeRT successfully evacuated patients on 24 of 27 missions launched (89%). Three patients were too unstable for ALeRT evacuation. Of the 13 remaining activations, four patients died and nine patients improved sufficiently for standard CCATT movement. The ALeRT initiated pumpless extracorporeal lung assistance six times, but only once to facilitate evacuation. Two patients were supported with full extracorporeal membrane oxygenation support after evacuation due to progressive respiratory failure.ALeRT successfully transported 24 casualties from the combat zones to Germany. Without the ALeRT, these patients would have remained in the combat theater as significant consumers of limited deployed medical resources. Pumpless extracorporeal lung assistance is already within the ALeRT armamentarium, but has only been used for one aeromedical evacuation. Modern extracorporeal membrane oxygenation systems hold promise as a feasible capability for aeromedical evacuation. |
| Databáze: | OpenAIRE |
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