Pitt, UPMC to study hemorrhaging in trauma patients

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Ever since the advent of trauma centers in the 1970s, surgeons have realized that the human body never evolved to survive such severe trauma. Why would it? Severe trauma historically caused death.

That may explain why inflammation and coagulation problems can prevent blood clotting in trauma patients, leading to uncontrolled hemorrhaging. The condition known as "coagulopathy" is deadly if trauma-center physicians cannot quickly re-establish clotting, said Brian S. Zuckerbraun, chief of trauma and acute care surgery at UPMC Presbyterian.

Understanding why coagulopathy occurs, and developing treatments for it, are the goals of a $23.8 million National Institutes of Health grant involving about 10 research centers. The University of Pittsburgh Graduate School of Public Health, which will coordinate the five-year study, and UPMC stand to receive $6.5 to $7 million.

The Trans-Agency Consortium for Trauma-Induced Coagulopathy -- TACTIC -- will receive funding from the National Heart, Lung and Blood Institute and the U.S. Department of Defense, which is seeking battlefield treatments for coagulopathy.

Four DOD studies already are under way, including a Pitt study, to develop coagulopathy treatments. The DOD studies will send blood samples and data to TACTIC, which the Epidemiology Data Center at the Pitt graduate school will process and analyze. Twelve other research projects, including a study involving Dr. Zuckerbraun to determine inflammation's role in hemorrhaging, are included in the grant. Their collective goal is to explain the biological process or mechanism that causes coagulopathy.

TACTIC also hopes to develop a method to identify trauma victims prone to the problem so doctors can take quick action to save lives by re-establish the blood's ability to clot.

"We are trying to figure out who clots and who doesn't. That's the question, and we don't know the answer. That's why we are doing this," said Stephan Wisniewski, senior associate dean and codirector of the Epidemiology Data Center.

Trauma is the major cause of death for people younger than 34 and the third leading cause of death in the United States, a Pitt news release states. Uncontrollable hemorrhaging caused by coagulopathy represents "the major cause of preventable deaths," the NIH reports. "Each year, nearly 50 million traumatic injuries in the United States result in 170,000 deaths."

David Templeton: dtempleton@post-gazette.com or 412-263-1578.


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