Multiple organ failure (MOF) is a serious, often fatal sequelae of visceral ischemia, resuscitation after severe hemorrhage, sepsis, or following traumatic injury. The overall long term goal of this proposal is to elucidate the humoral factors that contribute to the regulation of splanchnic blood flow during hemorrhage/reperfusion injury. The endogenous humoral factors that contribute to splanchnic blood flow that will be studied include vasoactive eicosanoids and nitric oxide (NO). The exogenous humoral factors investigated include platelet derived vasoconstrictors and oxygen-derived free radicals (ODFRs) formed during hemorrhage/reperfusion injury. Our long term goal is to investigate the specific mechanisms involved in the regulation of the enzymes responsible for eicosanoid and nitric oxide synthesis and degradation during shock states which will contribute to the development of treatment strategies designed to maintain splanchnic blood flow and visceral function following shock. Acute hemorrhage followed by reperfusion will be used either as a primary injury or as an initial injury followed by a second insult to examine the following specific aims: 1) To determine the role of ODFRs on splanchnic eicosanoid synthesis and NO synthesis following early hemorrhagic shock and reperfusion; 2) to determine the role of ODFR on the regulation of splanchnic blood flow following hemorrhagic shock and reperfusion; 3) To determine the role of local platelet eicosanoid and serotonin release in the splanchnic vascular bed following hemorrhagic shock and reperfusion; 4) To determine the role of a second trauma (endotoxin shock, hemorrhage) on splanchnic eicosanoid and NO synthesis and splanchnic blood flow following initial hemorrhagic shock. This proposal will utilize several strategies to determine the role of ODFRs on splanchnic eicosanoid and NO synthesis and splanchnic blood flow during shock. The first strategy will examine the effects of hemorrhage/reperfusion injury on splanchnic eicosanoid and nitric oxide synthesis and release. These studies will determine the location and molecular mechanisms involved with the regulation of the enzymes responsible for splanchnic eicosanoid and nitric oxide synthesis during hemorrhage/reperfusion injury. The second strategy is to examine the effects of ODFRs on splanchnic blood flow following hemorrhage/reperfusion injury. The third strategy is to examine the contribution of platelets to splanchnic vasoconstriction during hemorrhage/reperfusion by release of serotonin and thromboxane. The fourth strategy is to determine the effect of a second trauma (hemorrhage, endotoxin, morphine etc.) on the splanchnic eicosanoid and nitric oxide synthesis and splanchnic blood flow following initial hemorrhage.

Agency
National Institute of Health (NIH)
Institute
National Institute of General Medical Sciences (NIGMS)
Type
Specialized Center (P50)
Project #
5P50GM038529-09
Application #
5212116
Study Section
Project Start
Project End
Budget Start
Budget End
Support Year
9
Fiscal Year
1996
Total Cost
Indirect Cost
Galvagno Jr, Samuel M; Fox, Erin E; Appana, Savitri N et al. (2017) Outcomes after concomitant traumatic brain injury and hemorrhagic shock: A secondary analysis from the Pragmatic, Randomized Optimal Platelets and Plasma Ratios trial. J Trauma Acute Care Surg 83:668-674
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
Galvagno Jr, Samuel M; Fox, Erin E; Appana, Savitri N et al. (2017) Outcomes Following Concomitant Traumatic Brain Injury and Hemorrhagic Shock: A Secondary Analysis from the PROPPR Trial. J Trauma Acute Care Surg :
Deng, Xiyun; Cao, Yanna; Huby, Maria P et al. (2016) Adiponectin in Fresh Frozen Plasma Contributes to Restoration of Vascular Barrier Function After Hemorrhagic Shock. Shock 45:50-54
Matijevic, Nena; Wang, Yao-Wei W; Holcomb, John B et al. (2015) Microvesicle phenotypes are associated with transfusion requirements and mortality in subjects with severe injuries. J Extracell Vesicles 4:29338
Kozar, Rosemary A; Pati, Shibani (2015) Syndecan-1 restitution by plasma after hemorrhagic shock. J Trauma Acute Care Surg 78:S83-6
Hobson, Charles; Singhania, Girish; Bihorac, Azra (2015) Acute Kidney Injury in the Surgical Patient. Crit Care Clin 31:705-23
Adams, Sasha D; Cotton, Bryan A; Wade, Charles E et al. (2013) Do not resuscitate status, not age, affects outcomes after injury: an evaluation of 15,227 consecutive trauma patients. J Trauma Acute Care Surg 74:1327-30
Radwan, Zayde A; Bai, Yu; Matijevic, Nena et al. (2013) An emergency department thawed plasma protocol for severely injured patients. JAMA Surg 148:170-5
Dial, Elizabeth J; Tran, Duy M; Hyman, Ari et al. (2013) Endotoxin-induced changes in phospholipid dynamics of the stomach. J Surg Res 180:140-6

Showing the most recent 10 out of 201 publications