Emergency Superdeep Hypothermia in Circulatory Arrest Caused by Massive Blood Loss: from the Experience of Tactical and Special Exercises

Abstract

Summary. The aim of the study is to evaluate the possibility of using the technology of emergency superdeep hypothermia (ESH), which consists in rapid cooling of vital organs (up to 10 °C) and the whole body (up to 20 °C), in the conditions of simulation of stage treatment of the wounded with traumatic cardiac arrest (TCA) during the annual tactical-special military-medical exercise “Ochag” in the training center of the Military Medical Academy named after S.M. Kirov. Materials and research methods. A mobile resuscitation and surgical team consisting of two surgeons, one anesthesiologist-surgeon, an anesthesia nurse, and an operating room nurse was formed for the study, which was placed in a reinforced concrete bunker located slightly away from the main evacuation routes for the wounded (simulants). The personnel of the team, represented by the staff of the Special Medical Unit (SMU) of the Military Medical Academy, was reinforced by a surgeon trained in the use of extracorporeal membrane oxygenation and experienced in the use of this technology in the clinic in order to practice new technologies. The main tasks of the team included: primary surgical care of seriously wounded patients in case of a small incoming flow and primary medical and sanitary care in case of mass admission of the wounded. Results of the study and their analysis. The results of the study showed the potential possibility — primarily from the point of view of logistics and organization — of medical evacuation of a casualty in the state of ESH between the deployed stages of medical care. In the course of the experiment it was established that the duration of medical evacuation in hypothermic circulatory arrest should be less than 120 min. It is concluded that it is necessary to carry out additional research to determine the optimal parameters of the application of the ESG technique for the rescue of victims with TCA.