The US navy is bankrolling an Australian scientist’s research to slow hemorrhaging and buy time for emergency response teams.
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An Australian researcher who developed a suspended animation drug that could save wounded soldiers has been forced to seek funding from the US navy. As more Australians die on the battlefield of Afghanistan and other wars around the planet, one man holds the key to saving more lives.
The Australian government is not financing that man, however, and his life-saving drug, so he has had to look overseas to the US Naval Medical Research Centre to receive vital funds.
Professor Geoffrey Dobson (above) from the Heart and Trauma Research Laboratory in James Cook University’s physiology and pharmacology department came up with the treatment, that helps resuscitate a patient after a massive blood loss, after taking six months off work to research the idea.
He had earlier developed the drug adenocaine in the 1990s and it was used in 2006 to resuscitate the human heart.
He has been working diligently on the project, with no assistance from the government, and with PhD student, Hayley Letson, as his assistant.
Dobson and his team at JCU and Hibernation Therapeutics (a spin-off biotechnology company from JCU) are working with the US Naval Medical Research Centre and other US military researchers to develop two products.
One is a small volume adenocaine and magnesium resuscitation fluid for severe blood loss to be administered on location, enabling a casualty to be stabilised for evacuation for surgical care.
A second is an injectable product, which aims to arrest the whole body and brain for 10 to 20 minutes after catastrophic blood loss for immediate transport to a trauma facility.
Dobson said the goal was to have two US Food and Drug Administration-approved products from “bench to battlefield” in five years.
“The US Navy has been very supportive,” he says. “They have guaranteed $200,000 without any support from the Australian government, which I find very disappointing.
“In mid-2011, I was asked to submit a request to the Australian Defence Force for an $800,000 grant to help fast-track the research from a small animal [mice] to a large animal [pig] in order to elucidate the mechanisms behind its resuscitative action including reversal of coagulation disturbance.
“For reasons that still puzzle us the $800,000 grant was not acceptable and we were asked by the ADF to submit a $200,000 grant, and that grant was going to be matched by the US Navy.”
Dobson is at pains to point out that everyone he has dealt with at the ADF has been very supportive but he is somewhat bamboozled by the fact that the government does not want to support an initiative that can save lives not only the battlefield but also in general surgery.
“It costs the Australian Defence Force $1 million per year to send one solider to war,” he says. “At the moment we have approximately 1500 soldiers in Afghanistan and that is costing us $1.5 billion.
“I could be saving lives if extra funding were to be made available to me. The US Navy has already put equipment aboard a Qantas plane and sent it to James Cook University.
“If it were your son or daughter being sent overseas to fight in a war, what would you want your taxpayers’ money spent on?”
Hemorrhage or bleeding is responsible for up to 50 per cent of trauma deaths on the battlefield, and up to 20 per cent of these may be preventable. In the civilian setting, hemorrhage is responsible for 30 to 40 per cent of the 5.8 million trauma deaths each year globally, with one-third to one-half occurring in the pre-hospital environment.
Currently, combat medics in Afghanistan, or emergency first responder teams elsewhere,
have a limited range of pharmacological options that focus on rescuing and stabilising the heart of the critically wounded following catastrophic blood loss in pre-hospital environments or in mass casualty situations arising from a natural disaster or terrorist attack.
Dobson is fast developing a new treatment that will help enable a casualty to be rapidly evacuated to surgical care. The idea was developed first for cardiac surgery, after he studied natural hibernating animals. The treatment is now being modified for trauma.
Dobson has developed a small-volume adenocaine and magnesium solution in the rat and porcine models of severe to catastrophic hemorrhagic shock. The fluid has shown exciting and multiple benefits including hemodynamic, inflammatory and coagulation restorative functions with possible multi-organ and whole body protection.
“We could start trials on humans next year if I had $1 million,” Dobson says. “For trials on the whole body arrest I would need at least $2 million that would cover two years and I would need up to $5 million for five years.
“For the first time in the history of fluid resuscitation, we may have the capability to develop ‘one solution’ for surgical stabilisation of combat casualties suffering catastrophic blood loss with or without traumatic brain injury.
“At the moment, combat medics or emergency first responder teams have a limited range of pharmacological options for rescuing and stabilising the heart of soldiers or civilians following massive haemorrhage in the first few minutes of injury.”
The treatment will help enable a casualty to be rapidly evacuated to surgical care.
Dobson was invited by the US Navy to attend the 2012 Fort Lauderdale Military Health System Research Symposium in August, and is working with leaders as part of an evolving acquisition strategy.
“At Fort Lauderdale, I was invited to attend the TTCP-TP12 – combat casualty care – to update on the Adenocaine fluid resuscitation developments,” he says.
“I was also asked by the Supreme Allied NATO Commander Admiral James G. Stavridis to give a talk on new windows into far-forward resuscitation at the NATO Operations Medical Conference in Madrid earlier in the year.”
Dobson says he last received a response from the Australian government back in March this year from the Minister for Defence, Stephen Smith. The letter “encouraged” him to join the “Joint Health Command proposal to validate your results in a large animal model, managed in collaboration with the Australian Defence Force Professor of Military Medicine”.
The letter went on to say: “I consider this proposal to constitute tangible and significant support that could only enhance the credibility and potential of your work. Pending the outcome of this further assistance from the ADF may be considered.”
But Dobson said that his work was more advanced than what the federal government was offering. “I met with Lieutenant Colonel Michael Reade, the new professor of Military Medicine and Surgery late last year and was asked if I would like to collaborate with him,” Dobson says. “The problem is Prof Reade’s speciality is in the area of critical care of patients, not research into large animal massive blood loss. This [critical care] is an area he wished to pursue.
“I explained to Brigadier Stephan Rudzki (director, General Strategic Health Co-ordination, Joint Health Command, Department of Defence) that that our laboratory at JCU requires funds and that we needed to work with groups with established military/combat trauma models.
“Prof Reade had access to a sheep trauma model but we had already, in July 2011, translated our work from rat to pig, and wanted to move to an uncontrolled blood loss model, which we are planning to do with the US Navy and military.
“As a scientist I have a moral and ethical responsibility to find new ways to fast track my innovation and research to save soldiers with severe to catastrophic wounds. I cannot sit in the laboratory with little or no funding from Australia and hear of more Australian soldiers being killed on the battlefield.”w
Hayley Letson, Professor Dobson’s PhD candidate and research associate at JCU, will receive the Young Investigator Award at the American Heart Association for the second time running this year. She says the work is immensely important.
“I started working with Geoff in 2008 and there have been many challenging moments but also very exciting discoveries,” Letson says.
“He is amazingly innovative and the work we did with the drugs on pigs last year in Denmark was fascinating, however, having no funding and having to work at Woolworths full-time as a night-shift manager and then spend all day in the lab is very hard.
“While it is very important to get validation of your work and win awards, we need funding. The ability to develop one solution for surgical stabilisation will not only save lives on battlefields but be able to be used in everyday hospitals.”
A distinguished career
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Professor Geoff Dobson has more than 25 years' experience in animal comparative physiology, myocardial and muscle bioenergetics, surgical cardioplegia, heart and kidney preservation, haemorrhagic shock and cardiac arrest.
His research borrows from the “tricks” of natural hibernators to develop new therapeutics for use in cardiac surgery, general surgery and trauma.
He is the inventor of Adenocaine Cardioplegia (heart arrest solution) which is currently used in cardiothoracic surgery in the US, and shown to be superior in a randomised human trial in Verona, Italy.
Dobson is the founding director of Hibernation Therapeutics Global and is the recipient of two Australian Academy of Science Scientist’s Awards, and the Victor Chang Medal for pursuit of excellence in Heart Research.
In the past three years he has won prestigious awards in Trauma Resuscitation Science at the annual American Heart Association (AHA) meetings, the best-of-the-best abstracts, and his PhD Student Hayley Letson has won the Young Investigator Award for 2011 and 2012. He was recently elected a Fellow of the AHA.
He was also a speaker on new far-forward hypotensive resuscitation strategies at NATO’s Medical Operations Conference in Madrid (2011), and keynote speaker at the Townsville Hospital Trauma Day (August, 2011).