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Endurance and performance during multiple intense high +Gz exposures with effective anti-G protection.

BACKGROUND: In many high-intensity wartime scenarios, pilots may be required to fly multiple, strenuous missions during the same day. HYPOTHESIS: New anti-G protection allows fighter pilots to endure multiple high +G, exposures during several sorties in a limited time interval. METHODS: Nine well-trained centrifuge subjects were exposed to tactical aerial combat maneuvers using balanced pressure breathing during G (PBG) and an extended coverage anti-G suit. The centrifuge exposures consisted of five simulated sorties during a 4-h period, each consisting of four engagements with rapid onset cycles (6 G x s(-1)) varying between +4 G, and -9 GC. The subjects executed a tracking task before, during, and after each engagement and verbally indicated their effort level. Neck muscle strength was measured before and after the test. RESULTS: Seven of the nine subjects could endure all five sorties during the 4-h period. On a scale from 0 (no effort) to 11 (maximum possible effort), highest effort level during runs varied from 5.5 to 11 units (mean 8.7). Maximal heart rate varied from 140-173 bpm (mean 159) and minimum finger oxygen saturation from 75-93% (mean 88). Maximal peripheral and central light-loss varied from 0 to 100% (mean 71 and 40, respeclively). Three G-LOCs (two in the same subject) and four cases of near loss of consciousness occurred. The general fatigue recovery time varied from 9 to 48 h (mean 21). The tracking tests showed that performance deteriorated significantly during all G exposures; the neck muscle contraction was impaired by 12% (p = 0.035) after the C exposures. CONCLUSION: It is possible to train subjects to withstand five simulated flight sorties during a 4-h period with a total of up to 80 peaks to +9 Gz and 80 peaks to +8 Gz using PBCG and an extended coverage anti-G suit.

Aerospace Medicine↗

Alterations in MAST suit pressure with changes in ambient temperature.

A study was undertaken to test the hypothesis that change in ambient air temperature has an effect on MAST suit pressure according to the ideal gas law. Two different MAST suits were tested on Resusci-Annie dummies. The MAST suits were applied in a cold room at 4.4 degrees C and warmed to 44 degrees C. Positive linear correlations were found in nine trials, but the two suits differed in their rate of increase in pressure. Three trials using humans were conducted showing increased pressure with temperature but at a lesser rate than with dummies. A correlation of 0.5 to 1.0 mm Hg increase in MAST suit pressure for each 1.0 degrees C increase in ambient temperature was found. Implications are discussed for the use of the MAST suit in environmental conditions where the temperature changes.

Gravity Suits↗

A new device for the inflation of the antigravity suit.

The 'Schuco' orthopaedic tourniquet inflator can be simply converted into a suitable device for inflating an antigravity suit (G-suit). The antigravity suit may be used on neurosurgical patients undergoing procedures in the sitting position to help prevent hypotension and air embolism. The availability of this device may encourage the more widespread use of an antigravity suit in neuro-anaesthetic practice.

Brain↗

Cost-effective prevention of pulmonary embolus in high-risk trauma patients.

OBJECTIVE: To define the cost-effectiveness of screening ultrasound (US) and prophylactic inferior vena cava filters (VCF), approaches aimed at reducing the incidence of pulmonary embolus (PE) in high-risk trauma patients. DESIGN: Cost-effective analysis. MATERIALS AND METHODS: We constructed a decision tree with three approaches for PE prevention: no intervention, US, and VCF. Probabilities in each subtree were taken from published data. Sensitivity analyses evaluated all assumptions, probabilities, and outcomes for effects on baseline conclusions. RESULTS: US is more cost-effective than VCF, with a cost/PE prevented of $46,300 compared with $93,700. The strategies become equally cost-effective only when VCF are placed in the radiology suite and length of stay is > or = 2 weeks. CONCLUSIONS: US is the most cost-effective approach for PE prevention in high-risk trauma patients. VCF should be reserved for patients with an anticipated length of stay > or = 2 weeks who can safely have a filter placed in the radiology suite.

Aged↗

Compartment syndrome: a complication of use of the MAST suit.

A case of compartment syndrome following the use of a MAST suit is reported. The most significant factor in its development is prolonged application combined with severe hemodynamic compromise. Amputation was performed or death occurred in 50% of reported cases. Compartment pressure monitoring should be done in patients who require a MAST suit for more than 4 h.

Adolescent↗