US Navy Experience With Research on, and Development of, Hemoglobin-Based Oxygen Carriers

Following 9/11 and the advent of the wars in Iraq and Afghanistan, the Naval Medical Research Center (NMRC, Silver Spring, MD} embarked on an effort to develop an improved resuscitation fluid for use in the prehospital phase of care when blood is not available for transfusion. The long-range goal of...

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Bibliographic Details
Main Authors: Auker, Charles R, McCarron, Richard M
Format: Report
Language:English
Subjects:
BLOOD TRANSFUSION
CARDIAC ARREST
CIVILIAN POPULATION
FOOD
HEMORRHAGE
HEMORRHAGIC SHOCK
HOSPITALS
IRAQ
MEDICAL RESEARCH
MEDICAL SERVICES
MEDICINE
Medicine and Medical Research
MORTALITY RATE
NAVAL RESEARCH
OXYGEN
TRAUMA
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Summary:Following 9/11 and the advent of the wars in Iraq and Afghanistan, the Naval Medical Research Center (NMRC, Silver Spring, MD} embarked on an effort to develop an improved resuscitation fluid for use in the prehospital phase of care when blood is not available for transfusion. The long-range goal of this program was to develop a multifunctional blood substitute that had oxygen-carrying, hemostatic, and anti-inflammatory capabilities. A shorter-term goal was to deliver an oxygen-carrying resuscitation fluid to both military and civilian trauma medical communities via clinical trial(s) leading to approval from the US Food and Drug Administration (FDA). Trauma is the leading cause of mortality among young adults and causes significant disability among survivors. Exsanguinating hemorrhage causing hemorrhagic shock (HS} has been reported to account for 28% of combat deaths overall and for the preponderance of civilian and potentially salvageable combat deaths (60% vs. 33% and 6% for tension pneumothorax and airway obstruction, respectively). In Operation Iraqi Freedom (Iraq war) and Operation Enduring Freedom (Afghanistan war}, 83% to 87% of potentially survivable fatalities were caused by hemorrhage occurring before hospital arrival in 55% of cases. In the event of traumatic cardiopulmonary arrest, mortality remains unacceptably high (84-98%). Traumatic anemia as a result of blood loss has been correlated directly with mortality. Pub. in the Journal of Trauma Injury, Infection, and Critical Care, v70 n5, pS40-S41, May 2011.