Early Treatment in Shock
Abstract
Shock is a leading cause of death among American soldiers wounded in battle. If an injury is not immediately lethal, most deaths result from hemorrhagic shock or from its late sequelae, septic shock and multiple organ failure. The critical time in shock appears to be the period during which the patient is being resuscitated. Resuscitation is associated with a massive activation of the inflammatory reaction, producing immunosuppression, and rendering the patient vulnerable to sepsis and its sequelae. The goal of this research program is to develop new treatments for hemorrhagic shock which can be administered before or during initial resuscitation. These treatments are intended to be applied by front-line responders on the battlefield (and first responders in civilian life) as well as by fixed facilities, such as a Forward Surgical Team or a Combat Support Hospital. These agents must be non-toxic and have a very broad therapeutic ratio, so that they can be given safely to injured soldiers, and must be easy to administer under combat conditions. In previous work, the xanthine oxidase inhibitor allopurinol was found beneficial in a shock model (1). In current work, using an animal model of hemorrhagic shock (2), glutamine, glutamine-alanine dipeptide, and arginine have shown efficacy. (3,4) Studies with crocetin have also shown efficacy (5), but this agent is not available in a form which can be administered to patients. Others have advocated the use of DHEA, but studies in our laboratories have failed to show a useful effect (6). Studies with omega-3 fatty acids have shown promise, but are still at an early stage. The method of the research is to measure the response of the genome to hemorrhagic shock using microarray studies. The effect of these agents in patients will be compared to their effect in the animal model, to assess whether they will be effective in the clinical setting
Document Details
- Document Type
- Technical Report
- Publication Date
- Jun 01, 2008
- Accession Number
- AD1010645
Entities
People
- Charles Iii V. Way
Organizations
- University of Missouri–Kansas City