Trauma, Critical Care and Acute Care Surgery Research

Karen Brasel, M.D., M.P.H.

Dr. Karen Brasel

Title: Professor of Surgery; Assistant Dean for Graduate Medical Education; Residency Program Director; Vice Chair for Education 

Research Focus: Palliative care, trauma, and education

Current projects:

  • Use of decision aids in improving communication in the ICU
  • Predictors of ICU stay in patients with rib fractures

OHSU Profile

Mackenzie Cook, M.D.

Mac Cook

Title: Assistant Professor of Surgery

Research Focus: My research focus is on how to best bring primary palliative care to the bedside of critically ill and injured patients, regardless of their physical location. Surgical palliative care is a large and complex field. My focus is specifically on how we can best align patients goals / hopes with the realities of acute trauma care and complex critical care. This includes an educational component as we determine what skills are needed by what people in what circumstances, as well as a systems component focused on optimizing communication across the state.  

Current projects:

  • It's ok to say no: avoiding non-therapeutic trauma transfers

Select publications:

Bonanno AM, Kiraly LN, Siegel TR, Brasel KJ, Cook MR. Surgical palliative care training in general surgery residency: An educational needs assessment. Am J Surg. 2019 May;217(5):928-931.

Schultz KL, Brasel KJ, Zonies DH, Cook MR. Effective Palliative Care in the Trauma Setting. Am Surg. 2020 Nov;86(11):1441-1444.

Edsall A, Howard S, Dewey EN, Siegel T, Zonies D, Brasel K, Cook MR, Nagengast AK. Critical decisions in the trauma intensive care unit: Are we practicing primary palliative care? J Trauma Acute Care Surg. 2021 Nov 1;91(5):886-890. 

Schultz K, Howard S, Moreno K, Siegel T, Zonies D, Brasel K, Cook M. Teaching primary palliative care to general surgical residents: A novel pedagogical approach drawn from multi-disciplinary focus group data. Am J Surg. 2022 Jul;224(1 Pt B):396-399.

Schultz K, Howard S, Siegel T, Zonies D, Brasel K, Cook M, Moreno K. Supporting surgical residents learning clinical palliative care: Insights from multi-disciplinary focus groups. Am J Surg. 2022 Aug;224(2):676-680. 

OHSU Profile

David Farrell, Ph.D.

Dr. David Farrell

Title: Professor of Surgery

Research Focus: I am interested in the biochemistry, epidemiology, and regulation of gamma prime fibrinogen. We have found that gamma prime fibrinogen levels are correlated with COVID-19 disease severity.

Current projects:

  • The role of gamma prime fibrinogen in COVID-19

Select publications:

Kornblith LZ, Sadhanandhan B, Arun S, Long R, Johnson AJ, Noll J, Ramchand CN, Olynyk JK, Farrell DH. Gamma' fibrinogen levels as a biomarker of COVID-19 respiratory disease severity. Res Sq [Preprint]. 2022 Oct 21:rs.3.rs-2160004.

Farrell DH, Rick EA, Dewey EN, Schreiber MA, Rowell SE. γ' fibrinogen levels are associated with blood clot strength in traumatic brain injury patients. Am J Surg. 2020 Aug;220(2):459-463. 

Anderson TN, Farrell DH, Rowell SE. Fibrinolysis in Traumatic Brain Injury: Diagnosis, Management, and Clinical Considerations. Semin Thromb Hemost. 2021 Jul;47(5):527-537.

Dixon AL, McCully BH, Rick EA, Dewey E, Farrell DH, Morrison LJ, McMullan J, Robinson BRH, Callum J, Tibbs B, Dries DJ, Jui J, Gandhi RR, Garrett JS, Weisfeldt ML, Wade CE, Aufderheide TP, Frascone RJ, Tallon JM, Kannas D, Williams C, Rowell SE, Schreiber MA. Tranexamic acid administration in the field does not affect admission thromboelastography after traumatic brain injury. J Trauma Acute Care Surg. 2020 Nov;89(5):900-907. 

Extreme γ’ fibrinogen levels in COVID-19 patients www.medrxiv.org

OHSU Profile

Darren Malinoski, M.D.

Dr. Darren Malinoski

Title: Professor of Surgery

Research Focus: Maximizing every organ donation opportunity

Current projects:

  • The Donor Management Research Initiative (DMRI)

The DMRI focuses on optimizing the care of potential deceased organ donors such that we can maximize quality and quantity of organs available for transplantation. The first main project is the expansion of the United Network for Orgon Sharing (UNOS) donor management goals, (DMG) registry, it is a prospective database of all deceased organ donors from participating organ procurement organizations that includes their critical care parameters and graft outcomes. The second project is completing primary and secondary analyses of multi site "hypothermia vs machine prefusion to protect against kidney delayed graft function" randomized control trial. 

Select publications:

Niemann CU, Feiner J, Swain S, Bunting S, Friedman M, Crutchfield M, Broglio K, Hirose R, Roberts JP, Malinoski D. Therapeutic Hypothermia in Deceased Organ Donors and Kidney-Graft Function. N Engl J Med. 2015 Jul 30;373(5):405-14.

Malinoski DJ, Patel MS, Daly MC, Oley-Graybill C, Salim A; UNOS Region 5 DMG workgroup. The impact of meeting donor management goals on the number of organs transplanted per donor: results from the United Network for Organ Sharing Region 5 prospective donor management goals study. Crit Care Med. 2012 Oct;40(10):2773-80. 

Kotloff RM, Blosser S, Fulda GJ, Malinoski D, Ahya VN, Angel L, Byrnes MC, DeVita MA, Grissom TE, Halpern SD, Nakagawa TA, Stock PG, Sudan DL, Wood KE, Anillo SJ, Bleck TP, Eidbo EE, Fowler RA, Glazier AK, Gries C, Hasz R, Herr D, Khan A, Landsberg D, Lebovitz DJ, Levine DJ, Mathur M, Naik P, Niemann CU, Nunley DR, O'Connor KJ, Pelletier SJ, Rahman O, Ranjan D, Salim A, Sawyer RG, Shafer T, Sonneti D, Spiro P, Valapour M, Vikraman-Sushama D, Whelan TP; Society of Critical Care Medicine/American College of Chest Physicians/Association of Organ Procurement Organizations Donor Management Task Force. Management of the Potential Organ Donor in the ICU: Society of Critical Care Medicine/American College of Chest Physicians/Association of Organ Procurement Organizations Consensus Statement. Crit Care Med. 2015 Jun;43(6):1291-325. 

Malinoski DJ, Daly MC, Patel MS, Oley-Graybill C, Foster CE 3rd, Salim A. Achieving donor management goals before deceased donor procurement is associated with more organs transplanted per donor. J Trauma. 2011 Oct;71(4):990-5; discussion 996. 

Malinoski DJ, Patel MS, Ahmed O, Daly MC, Mooney S, Graybill CO, Foster CE, Salim A; United Network for Organ Sharing (UNOS) Region 5 Donor Management Goals (DMG) Workgroup. The impact of meeting donor management goals on the development of delayed graft function in kidney transplant recipients. Am J Transplant. 2013 Apr;13(4):993-1000. 

OHSU Profile

Mitch Sally, M.D.

Dr. Mitch Sally

Title: Associate Professor of Surgery

Research Focus: I study and identify how best to manage organ donors after brain death to optimize transplantation outcomes. I am also studying the optimal threshold for transfusion after operations in patients with documented cardiovascular disease.

Current projects:

  • Optimizing critical care of donors for transplantation
  • The Transfusion after Operation (TOP) Trial

Select publications:

Swanson EA, Patel MS, Hutchens MP, Niemann CU, Groat T, Malinoski DJ, Sally MB. Critical care and ventilatory management of deceased organ donors impact lung use and recipient graft survival. Am J Transplant. 2021 Dec;21(12):4003-4011.

Sally MB, Ellis MK, Hutchens M, Groat T, Swanson E, Patel MS, Niemann CU, Malinoski DJ. Deceased organ donor factors influencing pancreatic graft transplantation and survival. Clin Transplant. 2019 Jun;33(6):e13571. 

Crannell WC, Sally M, McConnell K, Connelly C, Maynard E, Dewey E, Abt P, Enestvedt CK. Thromboelastography profiles for controlled circulatory death donors: Validating the role of heparin. Clin Transplant. 2022 Feb;36(2):e14518.

Hawkins JS, Wells CE, Casey BM, McIntire DD, Leveno KJ. Nifedipine for Acute Tocolysis of Preterm Labor: A Placebo-Controlled Randomized Trial. Obstet Gynecol. 2021 Jul 1;138(1):73-78.

Sally MB, Ewing T, Crutchfield M, Patel MS, Raza S, De La Cruz S, Zatarain J, Malinoski DJ; United Network for Organ Sharing (UNOS) Region 5 Donor Management Goals (DMG) Workgroup. Determining optimal threshold for glucose control in organ donors after neurologic determination of death: a United Network for Organ Sharing Region 5 Donor Management Goals Workgroup prospective analysis. J Trauma Acute Care Surg. 2014 Jan;76(1):62-8; discussion 68-9.

OHSU Profile

Martin Schreiber, M.D.

schreiber

Title: Professor and Head of Trauma, Critical Care and Acute Care Surgery

Research Focus: I am interested in resuscitation, hemorrhage control, novel blood products as well as the coagulation and inflammatory response to trauma. The Donald D. Trunkey Center for Civilian and Combat Casualty Care serves as a core for clinical, translational and basic science research related to trauma and critical care.

Current projects:

  • We have 45 active IRB protocols and 3 active IACUC protocols within the OHSU trauma division

Select publications:

Webb AJ, Oetken HJ, Plott AJ, Knapp C, Munger DN, Gibson E, Schreiber M, Barton CA. The impact of low-dose aspirin in the Brain Injury Guidelines on outcomes in traumatic brain injury: A retrospective cohort study. J Trauma Acute Care Surg. 2023 Feb 1;94(2):320-327.

Brito AMP, Schreiber MA, El Haddi J, Meier EN, Rowell SE. The effects of timing of prehospital tranexamic acid on outcomes after traumatic brain injury: Subanalysis of a randomized controlled trial. J Trauma Acute Care Surg. 2023 Jan 1;94(1):86-92.

Tobias J, Labuz DF, Cunningham A, Dixon A, Selesner L, Moss L, Dewey E, Haley KM, Burns E, Schreiber M, Wilson R, Hamilton NA, Jafri MA. Venous thromboembolic screening in pediatric trauma: A prospective cohort study of risk-stratified ultrasonography. J Trauma Acute Care Surg. 2023 Jan 1;94(1):107-112.

Hoyos Gomez T, El Haddi SJ, Grimstead-Arnold SL, Schreiber MA. The effect of the Belmont rapid infuser on cold stored whole blood coagulability. Injury. 2023 Jan;54(1):29-31.

Henry R, Liasidis PK, Olson B, Clark D, Gomez TH, Ghafil C, Ding L, Matsushima K, Schreiber M, Inaba K. Disparities in Care Among Gunshot Victims: A Nationwide Analysis. J Surg Res. 2023 Mar;283:59-69.

OHSU Profile