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Injury and Oxygen

Battlefield wounds and disasters in remote areas often lead to patient evacuation by air. UNLV’s Barbara St. Pierre Schneider is exploring how cabin pressure during such flights may hinder trauma recovery.

People  |  Mar 25, 2015  |  By Kevin Dunegan
Barbara St. Pierre Schneider poses in her lab

UNLV Associate Professor of Nursing Barbara St. Pierre Schneider. (Aaron Mayes / UNLV Photo Services)

Earthquakes, explosions, industrial accidents, car crashes -- each are forms of mayhem that leave crushing trauma in their wake. Barbara St. Pierre Schneider, an associate professor in the School of Nursing, is working to better understand the biological processes characterizing such "skeletal and muscle-crush injuries," and how they might best be treated. She is especially concerned with U.S. service personnel who have been injured on the battlefield.

Whether these injuries occur in military combat, during a terrorist attack, or in a natural disaster, crush-related injuries involve significant compression, a traumatic event that interrupts blood flow and damages the cell membrane of muscle fibers. Although the injury itself may not be immediately life threatening, damaged muscle can increase the risk for death down the road: In many cases ruptured muscles spill cellular contents, such as the muscle protein myoglobin, into the bloodstream. Myoglobin, for example, can cause kidney damage and failure.

Soldiers who experience skeletal muscle-crush injuries during combat face additional challenges. Often, the wounded must endure long flights to treatment centers. While unavoidable, these evacuations by air expose the wounded to hypobaria, a situation in which tissues may be deprived of sufficient oxygen, which can become a factor when the air pressure is equivalent to an altitude of 8,000 feet, or that of a typical plane's cabin pressure.

St. Pierre Schneider and her team are studying how hypobaric hypoxia affects the healing of injuries and are searching for potential treatments that counteract its effects. A previous St. Pierre Schneider study, for example, simulated the effects of air transport and examined the effect of hypobaric hypoxia on genes within skeletal muscle. One major finding was that the simulated flights affected the genes affiliated with skin integrity, but had no apparent effect on inflammatory genes in skeletal muscle.

To further her hyperbaric hypoxia crush-muscle research, St. Pierre Schneider is expanding the capabilities of her lab. She recently received grant funding to purchase a combined cell sorter/flow cytometer, an instrument that allows scientists to measure and analyze the inner workings of cells. Having the instrument, says St. Pierre Schneider, will enhance UNLV's research capacity and the university's science, technology, engineering, and mathematics (STEM) program.

St. Pierre Schneider's studies in muscle injury recovery are guiding techniques in aeromedical evacuation, and her work has been featured in multiple publications, including Aviation, Space and Environmental Medicine and Innate Immunity.