Division of Trauma/Critical Care, Department of Surgery, University of Cincinnati, 231 Albert Sabin Way, PO Box 670558, Cincinnati, OH 45267-0558, USA.
Respir Care. 2012 Aug;57(8):1305-13. doi: 10.4187/respcare.01881.
The conflicts in Iraq and Afghanistan have seen the advancement of combat medicine. The nature of the conflicts, with troops located in remote areas and faced with explosive ordinance designed to focus massive injuries on dismounted personnel, have forced military medical personnel to adapt accordingly. There has been a rekindling of interest in the use of tourniquets to stop exsanguination from extremity wounds, as well as in the transfusion of fresh whole blood from walking blood banks. These previously discarded techniques, born on battlefields long ago, have been refined and perfected and have led to an unprecedented survival for our wounded warriors. New developments in the field of applied hemostatic agents, damage control surgical techniques, and the implementation of an efficient evacuation system have also contributed to these results. The field of combat medicine has taken several concepts initially designed in civilian settings, such as temporary abdominal packing and vascular shunting, and adapted them to the military setting to provide state of the art trauma management to our troops in combat. In turn, developments in the resuscitation of the trauma patient, using increased blood and plasma products and less crystalloid, have been pioneered in conflict and transitioned to the civilian sector. Advancements made during the wars in Iraq and Afghanistan, as well as those still being developed, will shape the care of the injured patient, in both civilian and military settings, for the foreseeable future.
伊拉克和阿富汗的冲突推动了战斗医学的发展。这些冲突的性质是，部队驻扎在偏远地区，面临着旨在使下车人员遭受大量伤害的爆炸物，这迫使军事医务人员相应地进行调整。重新燃起了使用止血带止血的兴趣，以及从流动血库输注新鲜全血。这些以前被丢弃的技术，源于很久以前的战场上，经过改进和完善，使我们的受伤战士获得了前所未有的生存机会。在止血剂、损伤控制性外科技术的应用领域的新发展，以及高效疏散系统的实施，也促成了这些结果。战斗医学领域采用了最初在民用环境中设计的一些概念，例如临时腹部填塞和血管分流，并将其适应于军事环境，为战斗中的部队提供最先进的创伤管理。反过来，创伤患者复苏方面的发展，使用更多的血液和血浆制品，减少晶体液，也在冲突地区和民用部门得到了先驱性的应用。在伊拉克和阿富汗战争期间取得的进展，以及正在开发的进展，将在可预见的未来塑造民用和军事环境中受伤患者的治疗。
