Hyperkalemia will clearly continue to be a concern in the treatment of combat casualties. The risk of death from hyperkalemia-induced cardiac arrhythmias is significant in the absence of renal replacement therapy (RRT). Rapid evacuation out of Iraq and Afghanistan ensured that most hyperkalemia occurred further up the evacuation chain, thereby limiting the need for non-RRT hyperkalemia treatment options in austere medicine. In future theaters of operation, the military research community must prepare for prolonged field care and extended evacuation times. One implication of the delay is that complications of combat injury, including life-threatening hyperkalemia, will be more frequently managed in the far forward deployed setting. To address this unmet medical need for the military, we plan to develop a forward care medical devices to treat hyperkalemia. In this study two medical devices will be developed, intra-peritoneal dialysis and intra-abdominal mesh packing devices, to reduce systemic potassium levels in austere medical treatment environments. The benefits of our forward care medical device are three-fold: 1) stabilizes hyperkalemia patients to endure prolonged field care and delayed evacuation, 2) is logistically feasible to implement for field use, and 3) expands hyperkalemia treatment options to include transport on aircraft with limited medical capability.
