Traumatic injury is a medical nightmare. If the initial injury doesn't kill patients, many still have to contend with a deadly bleeding syndrome called coagulopathy. A new five-year, $23.8 million grant will support research at the Oklahoma Medical Research Foundation and other institutes to understand the cause and find new therapies for coagulopathy.
OMRF scientist Charles Esmon, Ph.D., will serve as a part of the Trans-Agency Consortium for Trauma-Induced Coagulopathy, or TACTIC, which will examine why bleeding becomes an unmanageable problem for some trauma patients.
“A large number of severe trauma patients die in the hospital because their blood won't clot,” said Esmon, who holds the Lloyd Noble Chair in Cardiovascular Biology at OMRF.
Trauma is the major cause of death in people under age 34 and the third leading cause of mortality in the U.S., with uncontrollable hemorrhage representing the major cause of preventable deaths, according to the National Institutes of Health. Each year there are nearly 50 million injuries in the U.S. that result in 170,000 deaths.
Little is known about the biological phenomena that lead to coagulopathy. When a person sustains a traumatic injury, whether on the battlefield or in a car accident, he typically suffers serious physical damage. Doctors treat the injuries and, if all goes well, the patient gradually heals. However, some patients, regardless of proper treatment, can suddenly suffer from uncontrolled bleeding and die. It is believed that the shock from the trauma induces a “storm” of coagulation and inflammatory problems that prevents blood from clotting.
“Those are the questions we're asking: Why does the blood become unable to clot, and how can we fix it?” Esmon said.
Led by University of Vermont Professor Emeritus of Biochemistry Kenneth Mann, Ph.D., the TACTIC study is a cooperative effort funded by the National Heart, Lung and Blood Institute that establishes a unique collaboration between the NIH and the Department of Defense.
“There are no analytical tools that allow emergency department staff to conclude that coagulopathy is occurring in trauma victims — we're starting from ‘ground zero,'” Mann said. “The physicians and staff are left without resources to guide an effective therapeutic approach.”