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.

Agency
National Institute of Health (NIH)
Institute
National Institute of General Medical Sciences (NIGMS)
Type
Specialized Center (P50)
Project #
5P50GM049222-20
Application #
8678943
Study Section
Special Emphasis Panel (ZGM1-PPBC-5)
Project Start
Project End
Budget Start
2014-06-01
Budget End
2015-05-31
Support Year
20
Fiscal Year
2014
Total Cost
$185,948
Indirect Cost
$64,413
Name
University of Colorado Denver
Department
Type
DUNS #
041096314
City
Aurora
State
CO
Country
United States
Zip Code
80045
Coleman, Julia R; Moore, Ernest E; Chapman, Michael P et al. (2018) Rapid TEG efficiently guides hemostatic resuscitation in trauma patients. Surgery 164:489-493
Banerjee, Anirban; Silliman, Christopher C; Moore, Ernest E et al. (2018) Systemic hyperfibrinolysis after trauma: a pilot study of targeted proteomic analysis of superposed mechanisms in patient plasma. J Trauma Acute Care Surg 84:929-938
Moore, Ernest E; Moore, Hunter B; Chapman, Michael P et al. (2018) Goal-directed hemostatic resuscitation for trauma induced coagulopathy: Maintaining homeostasis. J Trauma Acute Care Surg 84:S35-S40
Reisz, Julie A; Wither, Matthew J; Moore, Ernest E et al. (2018) All animals are equal but some animals are more equal than others: Plasma lactate and succinate in hemorrhagic shock-A comparison in rodents, swine, nonhuman primates, and injured patients. J Trauma Acute Care Surg 84:537-541
Stettler, Gregory R; Moore, Ernest E; Nunns, Geoffrey R et al. (2018) Rotational thromboelastometry thresholds for patients at risk for massive transfusion. J Surg Res 228:154-159
Nunns, Geoffrey R; Stringham, John R; Gamboni, Fabia et al. (2018) Trauma and hemorrhagic shock activate molecular association of 5-lipoxygenase and 5-lipoxygenase-Activating protein in lung tissue. J Surg Res 229:262-270
Moore, Hunter B; Moore, Ernest E; Chapman, Michael P et al. (2018) Plasma-first resuscitation to treat haemorrhagic shock during emergency ground transportation in an urban area: a randomised trial. Lancet 392:283-291
Kuldanek, Susan; Silliman, Christopher C (2018) Mortality after red blood cell transfusions from previously pregnant donors: complexities in the interpretation of large data. J Thorac Dis 10:648-652
Nunns, Geoffrey R; Moore, Ernest E; Stettler, Gregory R et al. (2018) Empiric transfusion strategies during life-threatening hemorrhage. Surgery 164:306-311
Slaughter, Anne L; Nunns, Geoffrey R; D'Alessandro, Angelo et al. (2018) The Metabolopathy of Tissue Injury, Hemorrhagic Shock, and Resuscitation in a Rat Model. Shock 49:580-590

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