Strong's Trauma Center Participates in National Research Study to Probe Body's Response to Burn and Trauma Injury

May 09, 2003

People who survive serious injuries caused by burn or trauma face a long and difficult recovery period riddled with many potentially fatal complications along the way. Researchers yearn to understand the critical features that can tip the delicate balance of a severely injured body toward recovery, and those factors that cause people to die from such injuries--sometimes weeks after the injury occurred. To help identify those factors that could help guide physicians in choosing the best treatment in response to a life-threatening injury, the National Institute of General Medical Sciences (NIGMS) is funding the largest study in the area of trauma and injury.

The five-year, $38 million grant was awarded to a consortium of 10 medical centers nationwide, including the Trauma Center at the University of Rochester Medical Center (URMC). During the grant period, clinical and basic scientists will attempt to tease apart the complex set of events culminating in the immune system's reaction to a traumatic injury. URMC will likely receive $2 million to fund the clinical and basic science research being conducted in Rochester.

In 1995, 148,000 Americans died and 2.6 million were hospitalized at a societal cost of $260 billion from trauma, sepsis and burn-related syndromes. Over the past decade, research approaches have not produced the medical breakthroughs necessary for further significant advances in trauma outcomes. This grant takes a unique approach by seeking to standardize trauma treatment and correlate a patient’s outcome to the way his or her genes respond to inflammation.

Inflammation is one common thread in a body's reaction to a traumatic injury. This seemingly harmless process--the reason an annoying mosquito bite itches so much or why a sore throat aches--is a necessary defense mechanism that can also turn into a deadly, often fatal cascade of events after a traumatic injury. Excessive inflammation can lead to body-wide injury and critical organ dysfunction that predisposes the trauma patient to infection and sepsis, a common cause of a fatal outcome after major injury.

"After years of research and inquiry, we still cannot accurately predict the magnitude of a patient’s response to injury and an individual’s chance of survival based on the extent of the injury. We are in search of effective treatments to minimize critical organ dysfunction and the risk of infection following major trauma, as well as a way to identify those trauma victims that would benefit from new treatments," Paul Bankey, M.D., chief of the Trauma/Burn Center at Strong Memorial Hospital, said. "By understanding how the body controls inflammation, we expect to not only increase the likelihood of survival, but also to favorably impact length of hospitalization, cost of treatment and quality of life," he added.

"Gluing" Together Resources

For some research, the intellectual and material resources available to individual laboratories, or even to small groupings of labs, are simply not enough to attack the problem. "Glue grants" such as this marshal the resources needed to adequately study and analyze the issue. Leading the project is Dr. Ronald G. Tompkins, a surgeon and biomedical engineer at Massachusetts General Hospital.

The researchers seek to study the complex interplay between the acute events that take place after a serious injury and how the body's immune system responds. An important goal of the project will be to develop standard operating procedures for burn and trauma patients. Currently, physicians have a limited number of standards to follow in the immediate care of burn and trauma patients.

In addition, physicians will examine blood at different times throughout a trauma patient’s acute and recovery stages for scientists to measure biomolecular changes and analyze them in relation to how a patient is doing at that moment in time. Ultimately, the research should help scientists develop ways to predict patient outcomes based upon certain molecular measurements, such as genetic fingerprints.

The team will be multifaceted, consisting of burn and trauma surgeons, critical care physicians, geneticists, cell biologists, physiologists, biostatisticians, mathematical modelers, bioinformatics specialists, and biomedical engineers.

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Germaine Reinhardt
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