OHSU

Research

The Division of Trauma at OHSU has an active research program, ranging from injury prevention activities to improving the care of patient in a trauma setting.  As an academic medical center, we encourage innovation and research that leads to improvements in care for patients.

Current projects include:

Efficacy and Storage of Frozen Blood (IRB #5694)

Anemia is a common problem in traumatically injured adults and has important prognostic implications for morbidity and mortality. These patients receive approximately 15% of blood transfused in the United States. During preservation under standard blood bank conditions, donor red blood cells (RBCs) undergo a series of functional and structural changes (referred to as a "storage lesion"), which manifests with various speeds as the age of the cells differ. This storage lesion includes alteration of nitric oxide (NO) metabolism, loss of NO bioactivity, depletion of 2,3-Diphosphoglycerate, changes in morphology, and increased frequency of hemolysis. Increased age of RBCs is associated with increased patient mortality, length of stay, infectious complications, and rates of organ failure. During periods of high demand and low donation, banked blood is often close to expiration. Cryopreserved blood represents a possible method of solving this problem by avoiding the storage lesion without reducing the available blood supply. The Trauma Research Lab hypothesizes that transfusion of cryopreserved blood will be superior to transfusion of older PRBCs with respect to physiologic, biochemical and clinical parameters and that transfusion of cryopreserved blood will not be inferior to transfusion of younger PRBCs with respect to the same parameters. We have initiated a prospective, randomized, double-blinded, multi-center study at five hospitals around the country.Three simultaneous comparisons will be conducted in parallel:frozen red blood cells (RBCs) versus newer packed red blood cells (PRBCs), frozen RBCs versus standard age PRBC, and standard age PRBC versus newer PRBC.Frozen RBCs will be prepared from younger PRBC units utilizing well-described techniques. Patients randomized to receive frozen RBCs, newer PRBCs, and standard age PRBCs will be compared with respect to measurable clinical outcomes. Eligible patients in include adult patients admitted to the trauma service at OHSU and who may require non-emergent blood transfusion. For more information, contact Jon Wright at (503) 494-4315 or 


Pragmatic, Randomized Optimal Platelet and Plasma Ratios (PROPPR, IRB #8284)

Many observational studies have reported good outcomes across a range of different blood product ratios.However, there have not been any randomized, clinical trials to provide a more definitive answer on which ratio provides better outcomes for bleeding patients. The objective of this study is to conduct a Phase III multi-site, randomized trial in subjects predicted to require a massive transfusion, comparing the efficacy of 1:1:1 transfusion ratios of plasma and platelets to red blood cells with the 1:1:2 ratio by evaluating 24-hour and 30-day mortality. For more information, contact Tahnee Groat at (503) 494-4315 or Samantha Underwood at (503) 494-8481 or 


Acupuncture for Sedation in the Intensive Care Unit (IRB #4058)

Many patients in the intensive care unit (ICU) require mechanical ventilation and sedation. The purpose of this study is to see if acupuncture can lower the amount of sedation needed during mechanical ventilation in the ICU. Acupuncture is a medical procedure in which hair-thin sterile needles are inserted at specific points on the body. Very little is known about acupuncture in patients who have been injured and are being cared for in the ICU.Previous studies have shown that acupuncture helped reduce pain and swelling in some patients. However, we do not know if acupuncture can lower the amount of sedation in the ICU. In order to study the affect of acupuncture on sedation requirements, subjects will be randomized to "fake" acupuncture or real acupuncture. Subjects randomized to fake acupuncture will receive sham needles. These needles retract into themselves much like a 'magic sword' rather than poking the skin.The other half of the subjects will receive real acupuncture. This is a pilot study to determine if it is possible to keep the treatment teams blinded to study interventions while evaluating the effects of acupuncture on sedation requirements. For more information, contact Kate Watson or Erika Simeon at (503) 494-4315 or 


Thrombelastography (TEG) Based Dosing of Enoxaparin (IRB #5520)

The prevention of deep vein thrombosis (DVT) in critically ill or injured patients is a major concern.A standard dosing regimen of enoxaparin (Lovenox ®) is used in high risk patients to prevent clotting complications.The purpose of this study is to determine if a test called the thrombelastogram (TEG) can better guide physicians in prescribing more effective dosing of enoxaparin compared to standard dosing in the prevention of DVTs.It will also compare the rate of clotting complications including DVT, superficial venous thrombosis, pulmonary embolisms, and bleeding complications in patients receiving TEG guided dosing to patients receiving standard prophylactic dosing.This is a multi-center study and is supported by the National Trauma Institute. For more information, contact Erika Simeon at (503) 494-4315 or 


Correction of coagulopathy with fresh frozen plasma (IRB #7010)

In current clinical practice, it is common for coagulopathy to be reversed utilizing fresh frozen plasma (FFP).There are clear recommendations for the utilization of FFP to treat coagulopathy in the setting of ongoing bleeding.The determination of coagulopathy most often utilizes standard laboratory tests of coagulation which include the prothrombin time (PT), international normalized ratio (INR), activated partial thromboplastin time (aPTT), fibrinogen, and platelet count.Unfortunately, these tests have significant shortcomings and may in fact be inadequate to determine coagulation status and/or risk of bleeding.Thrombelastography (TEG®) is a point of care assay that graphically and quantitatively depicts the entire clotting process from initial clot formation to clot breakdown.Because of its global analysis of clotting, TEG® may serve as a better tool for assessment of coagulopathy and risk of bleeding in comparison to more traditional tests of coagulation. For more information, contact Tahnee Groat at (503) 494-4315 or 

More Information

Inquires about Trauma studies can be directed to