Pathological Myeloid Activation After Sepsis and Trauma

Description

The goal of this observational study is to better understand what happens to circulating blood after a patient experiences severe trauma injury. The main questions it aims to answer are: Is severe human trauma associated with specific patterns of development in the hematopoietic stem cells of these patients? and Does the initial severe trauma injury create immunosuppression and increase risk of in-hospital sepsis? Participants in study will give blood samples and a waste sample of bone marrow at time of operative repair of traumatic orthopedic injuries, supply medical information and participate in surveys and assessments during recovery from their injury(ies). Researchers will compare severe trauma injury patients to elective hip repair patients to see if immunosuppression and specific development patterns occur in the trauma patient versus the otherwise healthy hip surgery patient.

Conditions

Trauma Injury, Sepsis, Immunosuppression, Chronic Critical Illness

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Study Overview

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Study Details

Study overview

The goal of this observational study is to better understand what happens to circulating blood after a patient experiences severe trauma injury. The main questions it aims to answer are: Is severe human trauma associated with specific patterns of development in the hematopoietic stem cells of these patients? and Does the initial severe trauma injury create immunosuppression and increase risk of in-hospital sepsis? Participants in study will give blood samples and a waste sample of bone marrow at time of operative repair of traumatic orthopedic injuries, supply medical information and participate in surveys and assessments during recovery from their injury(ies). Researchers will compare severe trauma injury patients to elective hip repair patients to see if immunosuppression and specific development patterns occur in the trauma patient versus the otherwise healthy hip surgery patient.

Pathological Myeloid Activation After Sepsis and Trauma Subtitle: Dysfunctional Myelopoiesis and Myeloid-Derived Suppressor Cells in Sepsis Pathobiology

Pathological Myeloid Activation After Sepsis and Trauma

Condition
Trauma Injury
Intervention / Treatment

-

Contacts and Locations

Gainesville

UF Health at Shands Hospital, Gainesville, Florida, United States, 32610

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

For general information about clinical research, read Learn About Studies.

Eligibility Criteria

  • 1. All adults age ≥ 18 years
  • 2. Blunt and/or penetrating trauma resulting in long bone or pelvic fractures requiring open reduction internal fixation or closed reduction percutaneous pinning
  • 3. Blunt and/or penetrating trauma patient with a. Injury Severity Score (ISS) greater than or equal to 25 b. ISS \> 15 and one of the following: i. \> 4 units of packed red blood cell or \>3 units of whole blood or \>1500 ml of autogenous blood product in the first 24 hours of admission ii. AIS (acute injury score) \> 2 spine iii. Shock on arrival (SBP \< 90)
  • 1. Patients not expected to survive greater than 48 hours.
  • 2. Prisoners.
  • 3. Pregnancy.
  • 4. Patients receiving chronic corticosteroids or immunosuppression therapies.
  • 5. Previous bone marrow transplantation.
  • 6. Patients with End Stage Renal Disease.
  • 7. Patients with any pre-existing hematological disease.
  • 8. Patients deemed to be futile care or have advanced directives limiting resuscitative efforts.
  • 9. Patients with severe congestive heart failure (NY Heart Association Class IV).
  • 10. Known HIV infection with CD4+ (clusters of differentiation) count \<200 cells/mm3
  • 11. Chronic liver disease with MELD (Model for End-Stage Liver Disease) score ≥15

Ages Eligible for Study

18 Years to 100 Years

Sexes Eligible for Study

ALL

Accepts Healthy Volunteers

No

Collaborators and Investigators

University of Florida,

Philip Efron, MD, PRINCIPAL_INVESTIGATOR, UF COM Department of Surgery

Study Record Dates

2028-09-30