Trauma remains the leading cause of years of life lost in the United States and multiple organ failure (MOF) is the primary cause of late postinjury death. The Human Subjects Core (HSC) will coordinate the patient-oriented research of the """"""""Trauma Primes Cells"""""""" RCTBPI Grant. Given that a large portion of this proposal focuses on the study of injured and/or critically ill patients, the HSC is recommended as an effective manner to coordinate the development and implementation of standard protocols, recruitment and consent of subjects, as well as collection and appropriate storage/distribution of samples and clinical data. This proposal for the HSC has four major functions: 1) to continue to maximize two-way translational research from basic to clinical science and vice-versa within the Center as well as through collaborations with other investigators;2) to conduct timely studies to investigate significant clinical questions regarding resuscitation protocols and management of postinjury critical care patients;3) to refine, improve and update scoring systems for monitoring critical care patients, most especially the Denver MOF score, and 4) to conduct hypotheses generating studies to stimulate new sets of questions at the basic and clinical science level. To support these functions, two strategies are proposed: 1) MOF database: this detailed clinical registry of over 2000 critically injured patients at risk for MOF, initiated over a decade ago, and to our knowledge, the largest, sustained clinical database of its kind;and 2) Tissue Databank: initiated 5 years ago during our last cycle, this consists of discarded tissue and fluid samples of patients included in the MOF database (therefore with complete clinical and laboratorial data) appropriately stored and available for translational research. Analysis of these data provides pivotal insights on risk factors, outcome and possible mechanisms for the pathogenesis of postinjury MOF as well as landmark findings with direct implications to resuscitation protocols, especially in the area of blood products use, and management of critical care patients. It is important to emphasize that trauma patients provide a particularly appealing subpopulation, mostly young and free of comorbid disease, minimizing confounding and facilitating the interpretation of the results. Findings in this population often have implications for the management of other critical care populations, amplifying the scope and impact of our findings. In addition, we are improving standardization of care, while ensuring protection of human subjects, and maximizing translational science.

National Institute of Health (NIH)
National Institute of General Medical Sciences (NIGMS)
Specialized Center (P50)
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Special Emphasis Panel (ZGM1-PPBC-5)
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University of Colorado Denver
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Lawson, Peter J; Moore, Hunter B; Moore, Ernest E et al. (2017) Preoperative thrombelastography maximum amplitude predicts massive transfusion in liver transplantation. J Surg Res 220:171-175
Moore, Frederick A; Moore, Ernest E; Billiar, Timothy R et al. (2017) The role of NIGMS P50 sponsored team science in our understanding of multiple organ failure. J Trauma Acute Care Surg 83:520-531
Stettler, Gregory R; Moore, Ernest E; Moore, Hunter B et al. (2017) Platelet adenosine diphosphate receptor inhibition provides no advantage in predicting need for platelet transfusion or massive transfusion. Surgery 162:1286-1294
Moore, Hunter B; Moore, Ernest E; Chapman, Michael P et al. (2017) Viscoelastic Tissue Plasminogen Activator Challenge Predicts Massive Transfusion in 15 Minutes. J Am Coll Surg 225:138-147
Clendenen, Nathan; Nunns, Geoffrey R; Moore, Ernest E et al. (2017) Hemorrhagic shock and tissue injury drive distinct plasma metabolome derangements in swine. J Trauma Acute Care Surg 83:635-642
Sauaia, Angela; Moore, Frederick A; Moore, Ernest E (2017) Postinjury Inflammation and Organ Dysfunction. Crit Care Clin 33:167-191
Slaughter, Anne L; Nunns, Geoffrey R; D'Alessandro, Angelo et al. (2017) The Metabolopathy of Tissue Injury, Hemorrhagic Shock and Resuscitation in a Rat Model. Shock :
Silliman, Christopher C; Kelher, Marguerite R; Khan, Samina Y et al. (2017) Supernatants and lipids from stored red blood cells activate pulmonary microvascular endothelium through the BLT2 receptor and protein kinase C activation. Transfusion 57:2690-2700
Reisz, Julie A; Slaughter, Anne L; Culp-Hill, Rachel et al. (2017) Red blood cells in hemorrhagic shock: a critical role for glutaminolysis in fueling alanine transamination in rats. Blood Adv 1:1296-1305
D?Alessandro, Angelo; Moore, Hunter B; Moore, Ernest E et al. (2017) Plasma succinate is a predictor of mortality in critically injured patients. J Trauma Acute Care Surg 83:491-495

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