Photo caption: Researchers and MedEvac personnel return from the helipad after a simulated emergency rescue using an autonomous care system. (Andrew Doerfler/University of Pittsburgh)
By Kat Procyk
Battlefields, disaster zones and rural communities share an urgent challenge: delivering health care in environments where access is limited—or even impossible.
In critical care, every minute counts. The “golden hour” refers to the brief, crucial window to save a patient’s life following a traumatic injury. Medical autonomous systems, unmanned technologies capable of delivering care before a patient reaches a hospital, have the potential to extend this window and improve survival rates for both service members and civilians alike.
The Department of Critical Care Medicine at the University of Pittsburgh School of Medicine hosted more than 220 attendees from different backgrounds, including government, industry and academic partners for the Medical Autonomous Care State of the Science (MACSOS) meeting on Sept. 16-17, 2025, at the University Club. Sponsored by the Defense Health Agency under the U.S. Department of Defense, the event centered on advancing the safety, reliability and trustworthiness of medical autonomous care systems, powered by AI and robotics, while promoting cross-disciplinary collaboration.
“The advances in AI, robotics and sensing technologies are bringing us closer to a future where autonomous systems can assess, stabilize and even treat patients in challenging environments,” said Ron Poropatich, professor of medicine, School of Medicine, and director of the Center for Military Medicine Research. “What once sounded like science fiction is now moving toward reality, but that progress comes with important questions. How do we design systems that augment—not replace—human judgment? And how can these capabilities extend care to places we cannot go?”
Hernando Gómez Danies, associate professor of critical care medicine, School of Medicine, alongside Poropatich and a multiorganizational scientific advisory committee, organized MACSOS as they both work on medical autonomous research systems.
One project funded by the U.S. Department of Defense, Trauma Care in a Rucksack (TRACIR), which Poropatich leads alongside Michael R. Pinsky, professor of critical care medicine, School of Medicine, and many other Pitt colleagues, developed an advanced physiologic resuscitation system named Resuscitation from shock using Functional hemodynamic monitoring (ReFit). ReFit is an automated, closed-loop algorithm that uses real-time data from the body, specifically from an arterial catheter, to guide precise treatment for severe blood loss. It’s been successfully tested on mammals in scenarios that simulate controlled and uncontrolled bleeding, whether the patient is stationary or being moved by ground or air.
Building on TRACIR, a newer system called Cardiovascular Resuscitation Using Informed Semi-Closed Loop (CRUISE), led by Gómez Danies is in development and being funded by the U.S. Department of Defense through the Combat Casualty Care Research Program. This next-generation prototype will use physiologic data inputs from both invasive and noninvasive monitors to help guide medical decisions. Unlike fully autonomous systems, CRUISE is semiautonomous, meaning it supports but doesn’t replace human decision-making in emergency resuscitation.
To build out the medical autonomous movement capability, Pitt is also one of the 35 members of the civilian-led Autonomous Aviation Research Consortium for Health Care Innovation and Education Empowerment (AARCHIE), established in 2024, operates out of the John Murtha Johnstown-Cambria County Airport in Johnstown, Pennsylvania, with numerous industry and academic partners to address the challenges in delivering prehospital medical care to remote hospitals and patients using advanced unmanned aerial vehicles technology.
“There’s no doubt in my mind that the path forward to propel medical autonomous care into becoming a reality will require experts to come together as we have for this meeting,” Gómez Danies said. “Together, we can foster and nurture collaborations that can transcend silos as we join forces across disciplines and institutions.”
MACSOS featured keynote speeches from Anantha Shekhar, senior vice chancellor for the health sciences and John and Gertrude Petersen Dean of the School of Medicine; Jonathan Woodson, seventh president of Uniformed Services University of the Health Sciences; and Matthew Quinn, science director for the Telemedicine and Advanced Technology Research Center (TATRC) at the U.S. Army Institute for Surgical Research (USAISR).