• Current AAST Resarch Projects

     

    2019-2020 Scholarships

    The AAST Research and Education Fund is funding three scholarships for 2019-2020. The scholarship recipients will receive their scholarship plaque at the 78th AAST Annual Meeting in Dallas, TX and will present their research findings at the 79th Annual Meeting of AAST & Clinical Congress of Acute Care Surgery in Waikoloa, HI.

     

    "The Impact Of Anticoagulant Solution, Processing Method And Storage Time On The Biochemical And Coagulation Profile Of Stored Whole Blood"

    Galinos Barmparas, MD
    Assistant Professor of Surgery
    Division of Acute Care Surgery and Surgical Critical Care
    Cedars-Sinai Medical Center

    Although blood components have been the main source of blood products for patients requiring massive transfusion, whole blood has now re-emerged as a resuscitative product that combines the properties of all blood components in a single bag, is easier to administer, has a decreased amount of anticoagulant and is safe in clinical practice. Despite the limited experience and outcome data in the civilian setting, low titer stored whole blood is being increasingly utilized by trauma centers as part of their massive transfusion protocol for trauma patients presenting with hemorrhagic shock and variation in the processing and storage of whole blood is inevitably being introduced by blood banks across these trauma centers. The impact of these practices on clinically important properties of the stored whole blood remain largely understudied. Current regulations pertinent to components of whole blood are being applied to stored whole blood, with limited however, data regarding the impact of these practices on its properties. With this research, we aim to address a gap in knowledge on how the utilized anticoagulant, processing method and storage time affect the biochemical and coagulation profile of stored whole blood by measuring markers of hemolysis, platelet function, coagulation disturbances and immunologic responses based on: (1) storage in two different, commonly utilized anticoagulants, i.e. CPD and CPDA-1, (2) processing by two, commonly applied processing methods, i.e. leukoreduction and irradiation, and (3) storage time. Findings from this research will provide data regarding clinically important properties of stored whole blood depending on commonly utilized processes and may serve for the development of best practices and regulations for the use and storage of whole blood.

     

    "P-Selectin-Dependent Pulmonary Arterial Thrombosis in Blunt Thoracic Trauma"

    Ian Brown, MD, PhD
    Assistant Professor of Surgery
    Division of Trauma, Acute Care Surgery and Surgical Critical Care<
    University of California Davis Medical Center

    In the setting of severe acute trauma, endothelial activation may occur, resulting in increased vascular permeability, leukocyte recruitment, and potentially, in situ thrombus formation. With blunt thoracic trauma, the natural history and consequences of endothelial activation and resulting pulmonary arterial thrombosis (PAT) are incompletely understood. This PAT differs from typical pulmonary embolus (PE) both in that presentation tends to be earlier after initial trauma and in natural history as PAT requires local endothelial activation and therefore may have mechanistic differences in terms of initiation and resolution. As with PE, current management may require early systemic anti-coagulation, which is not ideal in the setting of combined solid organ injury or combined traumatic brain injury. Our lab is focused on understanding the natural history of PAT. We previously developed a murine model of blunt thoracic trauma and found that in situ PAT in the model was dependent on the presence of the cell adhesion molecule P-selectin. By understanding the natural history of PAT and the role and regulation of P-selectin in this history, we seek to help determine the necessity of intervention and to investigate the efficacy of P-selectin blockade as an alternative to anti-coagulation for intervention.  More broadly, cell adhesion molecules such as P-selectin likely play a role in thrombosis in the setting of vascular injury, vascular repair, and injuries of ischemia and reperfusion. Understanding the biology of cell adhesion molecules such as P-selectin may therefore contribute to the continuing evolution of resuscitation paradigms that improve trauma-associated outcomes.

     

    "The Role of Neutrophil Mediated NETosis in Pulmonary Endothelial Damage Following Traumatic Injury"

    Jennifer Leonard, MD, PhD
    Assistant Professor of Surgery 
    Washington University