Closing the "care in the air" capability gap for severe lung injury: The landstuhl acute lung rescue team and extracorporeal lung support

Raymond Fang, Patrick F. Allan, Shannon G. Womble, Morris T. Porter, Johana Sierra-Nunez, Richard S. Russ, Gina R. Dorlac, Clayne Benson, John S. Oh, Sandra M. Wanek, Erik C. Osborn, Stephen V. Silvey, Warren C. Dorlac

Research output: Contribution to journalArticle

Abstract

Background: 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. Methods: 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. Results: 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. Conclusions: 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.

Original languageEnglish (US)
JournalJournal of Trauma - Injury, Infection and Critical Care
Volume71
Issue numberSUPPL. 1
DOIs
StatePublished - Jul 1 2011
Externally publishedYes

Fingerprint

Lung Injury
Air
Lung
Critical Care
Extracorporeal Membrane Oxygenation
Patient Transfer
Critical Illness
Respiratory Insufficiency
Germany
Registries

Keywords

  • Acute respiratory distress syndrome
  • Aeromedical evacuation
  • Extracorporeal membrane oxygenation
  • High-frequency ventilation
  • Military medicine

ASJC Scopus subject areas

  • Surgery
  • Critical Care and Intensive Care Medicine

Cite this

Closing the "care in the air" capability gap for severe lung injury : The landstuhl acute lung rescue team and extracorporeal lung support. / Fang, Raymond; Allan, Patrick F.; Womble, Shannon G.; Porter, Morris T.; Sierra-Nunez, Johana; Russ, Richard S.; Dorlac, Gina R.; Benson, Clayne; Oh, John S.; Wanek, Sandra M.; Osborn, Erik C.; Silvey, Stephen V.; Dorlac, Warren C.

In: Journal of Trauma - Injury, Infection and Critical Care, Vol. 71, No. SUPPL. 1, 01.07.2011.

Research output: Contribution to journalArticle

Fang, R, Allan, PF, Womble, SG, Porter, MT, Sierra-Nunez, J, Russ, RS, Dorlac, GR, Benson, C, Oh, JS, Wanek, SM, Osborn, EC, Silvey, SV & Dorlac, WC 2011, 'Closing the "care in the air" capability gap for severe lung injury: The landstuhl acute lung rescue team and extracorporeal lung support', Journal of Trauma - Injury, Infection and Critical Care, vol. 71, no. SUPPL. 1. https://doi.org/10.1097/TA.0b013e3182218f97
Fang, Raymond ; Allan, Patrick F. ; Womble, Shannon G. ; Porter, Morris T. ; Sierra-Nunez, Johana ; Russ, Richard S. ; Dorlac, Gina R. ; Benson, Clayne ; Oh, John S. ; Wanek, Sandra M. ; Osborn, Erik C. ; Silvey, Stephen V. ; Dorlac, Warren C. / Closing the "care in the air" capability gap for severe lung injury : The landstuhl acute lung rescue team and extracorporeal lung support. In: Journal of Trauma - Injury, Infection and Critical Care. 2011 ; Vol. 71, No. SUPPL. 1.
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AU - Porter, Morris T.

AU - Sierra-Nunez, Johana

AU - Russ, Richard S.

AU - Dorlac, Gina R.

AU - Benson, Clayne

AU - Oh, John S.

AU - Wanek, Sandra M.

AU - Osborn, Erik C.

AU - Silvey, Stephen V.

AU - Dorlac, Warren C.

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KW - Aeromedical evacuation

KW - Extracorporeal membrane oxygenation

KW - High-frequency ventilation

KW - Military medicine

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