In the military environment, injured soldiers undergoing medical evacuation via helicopter or mine-resistant ambush-protected vehicle (MRAP) are subjected to vibration and shock inherent to the transport vehicle. We conducted the present study to assess the consequences of such vibration on the acutely injured spinal cord. We used a porcine model of spinal cord injury (SCI). After a T10 contusion-compression injury, animals were subjected to 1) no vibration (n = 7-8), 2) whole body vibration at frequencies and amplitudes simulating helicopter transport (n = 8), or 3) whole body vibration simulating ground transportation in an MRAP ambulance (n = 7). Hindlimb locomotor function (using Porcine Thoracic Injury Behavior Scale [PTIBS]), Eriochrome Cyanine histochemistry and biochemical analysis of inflammatory and neural damage markers were analyzed. Cerebrospinal fluid (CSF) expression levels for monocyte chemoattractant protein-1 (MCP-1), interleukin (IL)-6, IL-8, and glial fibrillary acidic protein (GFAP) were similar between the helicopter or MRAP group and the unvibrated controls. Spared white/gray matter tended to be lower in the MRAP-vibrated animals than in the unvibrated controls, especially rostral to the epicenter. However, spared white/gray matter in the helicopter-vibrated group appeared normal. Although there was a relationship between the extent of sparing and the extent of locomotor recovery, no significant differences were found in PTIBS scores between the groups. In summary, exposures to vibration in the context of ground (MRAP) or aeromedical (helicopter) transportation did not significantly impair functional outcome in our large animal model of SCI. However, MRAP vibration was associated with increased tissue damage around the injury site, warranting caution around exposure to vehicle vibration acutely after SCI.

We studied the effects of time delay on blood gases, pH, and base excess in blood stored in glass and plastic syringes on ice and the effects of resulting errors on calculated alveolar-to-arterial PO2 difference (A-aDO2). Matched samples of dog whole blood were tonometered with gas mixtures of 5% CO2-12% )2-83% N2 (mixture A), 10% CO2-5% O2-85% N2 (mixture B), and 2.88% CO2-4% O2-93.12% N2 (mixture C). Tonometered blood samples were transferred to 5-ml glass (5G), 5-ml plastic (5P), and 3-ml plastic (3P) syringes and stored on ice. Blood gases were measured every 1 h up to 6 h. In 5G, PO2 progressively decreased in blood tonometered with mixture A but rose in blood tonometered with mixtures B and C. O2 saturation progressively fell in all cases. In 5G, blood PCO2 progressively rose regardless of which gas mixture was used, and pH as well as base excess progressively fell. The rise in PO2 was faster in plastic than in glass syringes, and O2 saturation always rose in plastic syringes. Differences between storage in plastic and glass syringes on PO2 change were greatest when initial blood PO2 was highest (mixture A). At the highest PO2, O2 exchange was faster in 3P than in 5P. The rise of PCo2 was just as fast in plastic as in glass syringes, but in both the rise in PCO2 was faster at a higher initial PCO2 (mixture B) than in lower initial PCO2 (mixtures B and C). Rates of PO2 and PCO2 change in matched samples were significantly faster in 3P than in 5P. Errors due to rises in PCO2 and PO2 cause additive errors in calculated A-aDO2, and when blood is stored in plastic syringes for > 1 h significant errors result. Errors are greater in normoxic blood, in which estimated A-aDO2 decreased by > 10 Torr after 6 h on ice in plastic syringes, than in hypoxic blood.

To lower the cost and improve accessibility of the rebreathing technique for measuring cardiopulmonary function during exercise, we implemented a fast-response infrared (IR) gas-analyzer system to simultaneously measure lung diffusing capacity, cardiac output lung tissue volume, and lung volume by a rebreathing technique in five healthy subjects at rest and during steady-state exercise. Interferences by water vapor and CO2 on the analyzer were determined and corrected for. During rebreathing, a gas mixture of 0.4% C2H2-0.3% CH4-9% He-30% O2, and either 0.3% C18O or 0.3% C16O in a balance of N2 was simultaneously sampled by both a mass spectrometer and the IR analyzer, permitting paired comparisons. Measurements obtained by the two devices were not significantly different. We conclude that this modified rebreathing technique using the IR analyzer is accurate for the measurement of cardiopulmonary function at rest and during exercise.

A method to estimate pulmonary diffusing capacity for O(2) (D(LO2)) during exercise based on routine O(2) and CO(2) transport variables is presented. It is based on the fitting of a mathematical model to gas exchange data. The model includes heterogeneity (described as two exchanging compartments), diffusion limitation and right-to-left shunt. Mass conservation equations and Bohr integration were solved to calculate partial pressures in each compartment. Diffusion was distributed with perfusion. Two-compartment ventilation and perfusion distributions were estimated at rest during conditions of negligible diffusion limitation. These distributions were used during hypoxic and normoxic exercise to obtain the D(LO2) from the model computations (D(LO2)2C) compatible with experimental data. Three normals, four sarcoid patients and four patients after lung resection were studied. An independent technique for carbon monoxide was used to provide experimental estimates of DLo2 (D(LO2)EXP, rebreathing technique for sarcoid patients and single breath for lung resection). D(LO2)2C was highly correlated with D(LO2)EXP (r2 = 0.95, P<0.001) and the slope of the regression line was not statistically different from 1. The mean (D(LO2)EXP - D(LO2)2C) difference was -1.0 +/- 7.4 ml min-1 mmHg-1. The results suggest that use of a refined analytical procedure allows for assessment of D(LO2) from routine O(2) and CO(2) measurements comparable with those obtained from independent carbon monoxide techniques. The method may be an alternative for estimates of D(LO2) during exercise.

This work investigates the effect of the contact surfaces on the biomechanical response of supine humans during wholebody vibration and shocks. Twelve participants were exposed to three-dimensional random vibration and shocks and were tested with two types of contact surfaces: (i) litter only, and (ii) litter with spinal board. The two configurations were tested with and without body straps to secure the supine human. The addition of the spinal board reduced the involuntary motion of the supine humans in most directions. There were significant reductions in the relative vertical accelerations at the neck and torso areas, especially during shocks (p < 0.01). The inclusion of body straps with the spinal board was more effective in reducing the relative motion in most directions when shocks were presented. This study shows that the ergonomic design of the human transport system and the underlying contacting surfaces should be studied during dynamic transport environments.