The Bellamy challenge: it's about time

@article{Dobson2014TheBC,
  title={The Bellamy challenge: it's about time},
  author={Geoffrey P. Dobson and Harry Letson and Douglas K. Tadaki},
  journal={Journal of the Royal Army Medical Corps},
  year={2014},
  volume={160},
  pages={15 - 9}
}
In 1984, Col. Ronald Bellamy launched a worldwide challenge to develop a new resuscitation fluid to aid survival after catastrophic blood loss on the battlefield. In 1996, after careful compromise among need, cube weight and efficacy, the US military and later coalition forces adopted 6% hetastarch (HES) fluids for early resuscitation. In the intervening years, evidence has amassed indicating that the HES fluids may not be safe, and in June 2013 the US Food and Drug Administration issued a… 
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13 Citations
Background Citations
8
Methods Citations
2
Results Citations
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13 Citations

Citation Type

Citation Type

Hemorrhagic Shock: A Widening Gap in Far Forward Medicine
TLDR
A small-volume IV or IO ALM therapy for noncompressible HS is developed and it is shown in preclinical models that it extends survival to 3 days, reduces abdominal bleeding by 60%, blunts inflammation, corrects coagulopathy, preserves platelet function, and prevents immunodeficiency.
Development of a small-volume resuscitation fluid for trauma victims
TLDR
Lower P-selectin in ALM-treated animals may indicate improved endothelial function, and reduced platelet dysfunction and inflammation, however this requires further investigation.
Volume Resuscitation in the Acutely Hemorrhaging Patient: Historic Use to Current Applications
TLDR
Current understanding of the resuscitation of the acutely hemorrhaging small animal (dog and cat) veterinary patient is described through evaluation of pre-clinical canine models of hemorrhage and resuscitation, clinical research in dogs and cats, and selected extrapolation from human medicine.
Mechanisms of early trauma-induced coagulopathy: The clot thickens or not?
TLDR
DIC with its diffuse anatomopathologic fibrin deposition appears to be a latter phase progression of TIC associated with unchecked inflammation and multiple organ dysfunction, but early TIC is not DIC because an increased thrombin-generating potential in vitro does not imply a clinically relevant thrombotic state in vivo.
Anesthesiologic and Surgical Experiences of the Spanish Role 2 Enhanced in Herat, Afghanistan
TLDR
These anesthesiological and surgical experiences of Role 2 Enhanced (Role 2E) in heart, Afghanistan from March to May 2014 can be helpful in future military deployments.
Intravenous Hydroxocobalamin Versus Hextend Versus Control for Class III Hemorrhage Resuscitation in a Prehospital Swine Model.
TLDR
Hydroxocobalamin restored blood pressure more effectively than no treatment and as effectively as hydroxyethyl starch but did not adversely affect coagulation.
Differential contributions of platelets and fibrinogen to early coagulopathy in a rat model of hemorrhagic shock.
ALM Fluid Therapy Leads to 72 hr Survival After Hemorrhagic Shock: a Model for Studying Differential Gene Expression and Extending Biological Time.
TLDR
A hallmark of the ALM-survival phenotype in heart and brain was an upregulation of amp-k, PGC-1α, sirt-1 and mitCO3 to presumably 'boost' mitochondrial function and ATP production, and a contrasting downregulation in liver.
Adenosine, lidocaine, and Mg2+ (ALM): From cardiac surgery to combat casualty care—Teaching old drugs new tricks
TLDR
A unifying hypothesis involving improved central, cardiovascular and endothelium coupling to maintain sufficient tissue oxygenation and reduce primary and secondary “hit” complications is proposed.
NaCl adenosine , lidocaine , and Mg 2 + occurs within 5 minutes : A ROTEM analysis
TLDR
Small-volume 7.5% NaCl resuscitation with ALM resuscitated MAP and corrected coagulopathy at 5 minutes, with further improvements at 60 minutes in clot kinetics, propagation, and firmness, indicating protection against hyperfibrinolysis.
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