Oxygen is commonly administered to patients after severe injuries. When these trauma patients have low oxygen levels, oxygen administration is clearly beneficial. However, many injured patients have normal or near normal oxygen levels, and the benefit of additional oxygen is unclear. In addition, evidence from non-trauma patients strongly indicates that too much oxygen can actually be harmful. This raises questions about how much, if any, oxygen is needed, and what oxygen levels should be targeted for trauma patients. The answers to these questions are unknown but are vital to treatment and outcomes of Service members injured during combat. We propose to determine the feasibility, safety, and effectiveness of a strategy to target physiologically normal oxygen levels, based on our prior work, to conserve oxygen and improve clinical outcomes in critically injured patients.

The project has high potential to inform and accelerate medical product development within the Combat Casualty Care Research Program (CCCRP) emphasized in the Fiscal Year 2019 Joint Warfighter Medical Research Program Focus Areas. Specifically, the proposal will address the CCCRP interest “to identify and develop medical techniques and materiel (medical devices, drugs, and biologics) for early intervention in life-threatening battle injuries and prolonged field care.” The applicability is broad, as the results will have potential to impact the care of all Service members injured during combat, as well as the hundreds of thousands of civilians with major trauma in the United States every year. Delivering and carrying oxygen is one of the biggest medical challenges in military operations, due to its relatively large size, weight, power requirements, and explosive potential. Our research will help to define more precisely, and likely limit, the amount of oxygen required to support military operations and to determine which Service members injured during combat are likely to benefit (or be harmed) by treatment with oxygen.

Our findings will provide immediately actionable, definitive results to develop and disseminate a clinical practice guideline for oxygen requirements in combat casualty care. In addition, our findings will directly impact and accelerate the development of materiel solutions such as portable oxygen concentrators and closed loop oxygenation/ventilation systems.