Project I-A (Adult Trauma Registry) and Project I-C (Pediatric Trauma Registry) will serve as the clinical foundations upon which all our other projects within our Trauma Center will be based. The constructs of early dysregulated systemic inflammation (Projects II, III, IV, V, VI, VII and VIII) following injury and the two-insult model of MOF are now well recognized, and have served as a framework for our predictive models of MOF. Risk factors for MOF can be categorized as follows: 1) tissue injury severity, 2) shock or ischemia-reperfusion, 3) severity of the inflammatory response, 4) host factors (including age, gender and co- morbidity), and 5) other factors (early blood transfusion, infections, secondary operative procedures)(with Project IX). Using various measures to quantify each risk category, MOF could be predicted as early as 12 hours following injury. Much of this work has regarded MOF as a dichotomous outcome. Recently, however, the view of MOF as a continuous spectrum of multiple organ dysfunctions has been emphasized. We hypothesize the following: 1. MOF is the result of dysregulated inflammatory response characterized by early systemic hyperinflammation and delayed immunosuppression; 2. Determinants of post-injury MOF can be identified and quantified; thereby allowing its early prediction after injury.
Our specific aims are 1, To examine and quantify postinjury MOF as a continuous spectrum of multiple organ dysfunctions; 2. To refine our measurement of the MOF risk factor categories; 3. To examine the effects of other events on the occurrence of MOF, specifically blood transfusion (with Project IX), secondary operative procedures and hyperosmolar therapy (with Project IV).
Showing the most recent 10 out of 291 publications
