Archive for the ‘research grant’ Category

NTI Studies Gain $1 Million in Funding from the Joint Warfighter Medical Research Program

Wednesday, October 28th, 2015

Funding from the Joint Warfighter Medical Research Program will support the continuation of two studies initially funded by the National Trauma Institute. Deemed to have significance for pre-hospital treatment of the war wounded, the studies by Jay Doucet, MD, University of California at San Diego, and Henry Cryer, MD, University of California at Los Angeles, were selected on the strength of their preliminary results.

Dr. Doucet’s study, Detection and Management of Non-Compressible Hemorrhage Using Vena Cava Ultrasound, postulates that ultrasonic assessment of the inferior vena cava (IVC) can detect and aid management of non-compressible hemorrhage in major trauma victims. As indicated in small clinical studies, observation of the diameter of IVC in both expiration and inspiration, as well as its collapsibility, can be a sensitive indicator of blood volume loss and hemorrhagic shock. Doucet’s study specifically aims to determine how accurate ultrasound assessment of the IVC is, compared to vital signs, as well as the measure’s ability to detect preclinical shock states.

This technique may predict those patients who will require transfusions, surgery or angiographic embolization. Additionally, the study will provide an opportunity to demonstrate the ability of handheld ultrasound devices to detect and monitor hemorrhagic shock in initial trauma care and in the ICU in both civilian and military trauma environments.

The investigation being led by Dr. Cryer, Transfusion Using Stored Fresh Whole Blood (FWB), will determine the appropriate shelf life of FWB by measuring changes in levels of coagulation factors and global clotting potential of banked units over time. Dr. Cryer’s earlier results demonstrated that filtered blood has a filtration lesion resulting in a coagulopathic product and some decrease in clotting capability over 35 days. Platelet transfusion may correct the filtration lesion seen, but further studies are needed to determine the exact timing and ratio of platelet transfusion required.

The follow-on effort will prospectively determine the effectiveness of trauma resuscitation using FWB compared to component therapy and its effects on markers of coagulation, fibrinolysis, inflammation and global hemostatic potential, as well as hospital outcomes including development of coagulopathy, infection, venous thromboembolism, multiple organ failure, total transfusion requirements, and mortality.

The Joint Warfighter Medical Research Program is a program of the Department of Defense Peer Reviewed Medical Research Program (PRMRP). Funding for this program is directed by Congress to “augment and accelerate high priority Department of Defense and Service medical requirements and to continue prior year initiatives that are close to achieving their objectives and yielding a benefit to military medicine.”