Saving Lives Past the Emergency Room

For people who have suffered a massive traumatic injury--from a car crash, building collapse, or other life-threatening event--modern health care is paradoxical in nature. While the emergency room is successful in prolonging lives, it is the body's system failures that eventually kill trauma patients. "If you look at the successes that medicine has had in our ability to capture individuals immediately after trauma, to resuscitate them, get them to the emergency room, we've been remarkably succes

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Also known as multi-organ dysfunction syndrome, this gradual, then hasty, cessation of vital organs is a major cause of posttraumatic event death. The reasons are obscure. "We really don't have a clue," says J. Perren Cobb, a surgery professor at Washington University in St. Louis. An attempt to grasp the nature of the problem and improve the situation came this past October when a $25 million, five-year grant was awarded from the National Institute of General Medical Sciences. The research involves 500 patients and some 45 investigators at 20 centers. This so-called glue grant, because it brings together scientists from a large number of institutions, is focused on understanding inflammation by using the knowledge and techniques spawned by human genome research.

The body's inflammatory response, says Timothy Buchman, a surgery professor at Washington University, is designed to control pathogens and remove damaged tissue from wounds. "These inflammatory molecules were designed ...

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