Early Treatment in Shock
Abstract
Shock is a leading cause of death among American soldiers wounded in battle. For injuries which are 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 Forward Surgical Teams or Field Hospitals. Such 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 to improve cardiac output and survival in a shock model (1). Also in earlier work, changes in cellular energy stores were defined. (2, 3, 4) In current work, glutamine and alanine-glutamine dipeptide have shown to enhance ATP recovery and suppress cytokine responses. (5, 6, 7) Studies continue on other agents, specifically as DHEA, crocetin, and insulin. (3, 4, 8, 9), omega-3 fatty acids, and arginine.
Document Details
- Document Type
- Technical Report
- Publication Date
- Jun 01, 2007
- Accession Number
- AD1010647
Entities
People
- Charles Van Way
Organizations
- University of Missouri–Kansas City