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
Landstuhl Regional Medical Center, Landstuhl, Germany.
J Trauma. 2011 Jul;71(1 Suppl):S91-7. doi: 10.1097/TA.0b013e3182218f97.
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.
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.
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.
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.
美国空军重症护理空中运输团队（CCATT）在运送重症伤病员方面的成功，促使军事医疗力量部署和伤亡护理实践发生了变化。即便如此，仍有一部分伤亡人员的转运超出了CCATT的能力范围。这些患者促使兰施图尔急性肺损伤救援团队（ALeRT）的成立，以填补“空中护理”能力缺口。
查询了2005年11月1日至2010年6月30日期间的ALeRT登记信息。此外，还审查了兰施图尔地区医疗中心将重症护理患者转送至东道国医疗中心的病例，以了解使用体外肺支持系统的情况。
在审查期间，美国中央司令部40次启动了ALeRT。在启动的27次任务中，ALeRT成功撤离了24名患者（89%）。有3名患者因病情过于不稳定而无法通过ALeRT撤离。在其余13次启动任务中，4名患者死亡，9名患者病情改善到足以由标准CCATT转运。ALeRT启动了6次无泵体外肺辅助，但仅1次用于协助撤离。由于进行性呼吸衰竭，有2名患者在撤离后接受了全体外膜肺氧合支持。
ALeRT成功地将24名伤员从战区运送到德国。如果没有ALeRT，这些患者将留在战区，大量消耗有限的已部署医疗资源。无泵体外肺辅助已在ALeRT的装备范围内，但仅用于一次航空医疗撤离。现代体外膜肺氧合系统有望成为航空医疗撤离的可行能力。
