Research

We aim to develop and evaluate innovative, effective acute trauma care technologies and training through collaborative efforts with industry, military, and academic partners.

Through this work, we can decrease the mortality and disability for all Minnesotans and members of the armed forces sustaining traumatic injuries. By conducting rigorous trauma care research in collaboration with our local business and military leaders, we have an opportunity to improve point of injury and resuscitative care that will decrease the mortality and disability for all Minnesotans and members of the armed forces sustaining traumatic injuries. We will accomplish this through:

Development and evaluation of innovative, effective acute trauma care, from point of injury through early post-injury care in austere, low resource, rural, and emergency care settings.
Development of technology and knowledge products deployable by both first responders and hospital-based health care workers that are applicable to military and non-military situations.

Foci

jeff

Rural Trauma Care

ii

Wound Management

ic

Infection Prevention

con

Prolonged Casualty Care

ico

Point of Injury

tr

Prehospital Care

tr

Resuscitation

 

Current Literature

Expand all

Suggested Readings

  1. Liu NT, Holcomb JB, Wade CE, Salinas J. Inefficacy of standard vital signs for predicting mortality and the need for prehospital life-saving interventions in blunt trauma patients transported via helicopter: A repeated call for new measures. J Trauma Acute Care Surg. 2017 Jul;83(1 Suppl 1):S98-S103. doi: 10.1097/TA.0000000000001482. PMID: 28452878.
  2. Liu NT, Holcomb JB, Wade CE, Batchinsky AI, Cancio LC, Darrah MI, Salinas J. Development and validation of a machine learning algorithm and hybrid system to predict the need for life-saving interventions in trauma patients. Med Biol Eng Comput. 2014 Feb;52(2):193-203. doi: 10.1007/s11517-013-1130-x. Epub 2013 Nov 22. PMID: 24263362.
  3. Lusczek, Elizabeth R. PhD; Muratore, Sydne L. MD; Dubick, Michael A. PhD; Beilman, Greg J. MD. Assessment of key plasma metabolites in combat casualties. Journal of Trauma and Acute Care Surgery: February 2017 - Volume 82 - Issue 2 - p 309-316. doi: 10.1097/TA.0000000000001277
  4. James M Bardes, Daniel J Grabo, Aimee LaRiccia, M. Chance Spalding, Zachary D Warriner, Andrew C Bernard, Melissa B Linskey Dougherty, Scott B Armen, Aaron Hudnall, Conley Stout, Alison Wilson. A multicenter evaluation on the impact of non-therapeutic transfer in rural trauma. Injury, 2022, ISSN 0020-1383, https://doi.org/10.1016/j.injury.2022.07.045.
  5. Brendan G. Carr, Ariel J. Bowman, Catherine S. Wolff, Michael T. Mullen, Daniel N. Holena, Charles C. Branas, Douglas J. Wiebe. Disparities in access to trauma care in the United States: A population-based analysis. Injury, Volume 48, Issue 2, 2017, Pages 332-338, ISSN 0020-1383. https://doi.org/10.1016/j.injury.2017.01.008.
  6. Newgard, Craig D., et al. Evaluation of rural vs urban trauma patients served by 9-1-1 emergency medical services. JAMA Surgery 152.1 (2017): 11-18.
  7. Jarman, Molly P., et al. Associations of distance to trauma care, community income, and neighborhood median age with rates of injury mortality. JAMA Surgery 153.6 (2018): 535-543.
  8. van Rein, Eveline AJ, et al. Development and validation of a prediction model for prehospital triage of trauma patients. JAMA Surgery 154.5 (2019): 421-429.
  9. Wandling, Michael W., et al. Association of prehospital mode of transport with mortality in penetrating trauma: a trauma system–level assessment of private vehicle transportation vs ground emergency medical services. JAMA Surgery 153.2 (2018): 107-113.
  10. Hashmi ZG, Kaji AH, Nathens AB. Practical Guide to Surgical Data Sets: National Trauma Data Bank (NTDB). JAMA Surgery. 2018;153(9):852–853. doi:10.1001/jamasurg.2018.0483
  11. Haider, Adil H., et al. Developing best practices to study trauma outcomes in large databases: an evidence-based approach to determine the best mortality risk adjustment model. Journal of trauma and acute care surgery 76.4 (2014): 1061-1069.
  12. Larson, L, Harry, M, Kosmata, P, Colling, K . Is it a matter of time? The effect of transfer time on femur fracture outcomes.Trauma Surg Acute Care Open 2021 Jun 17;6(1):e000701. doi: 10.1136/tsaco-2021-000701. eCollection 2021.
  13. JAMA's October issue: Caring for the Critically Ill Patient
     

2024 TCRTC Scholar Award Winner

We would like to congratulate Aaron Robinson, MD, on receiving a TCRTC Scholars Award! His project is titled, "Optimal Prehospital Airway Management with Patients with Major Trauma", and it will begin in early 2024.

2023 TCRTC Pilot Project Winners

We would like to congratulate our Pilot Project Winners! Their names, project titles, and brief descriptions are below:

Expand all

Eric Wise, MD: “Defining the physiologic properties of the peripheral venous system in surgical sepsis”

Dr. Wise a bariatric and general surgeon at the University of Minnesota and in CentraCare, in St. Cloud. He also has an active research program in vascular biology, in which he endeavors to characterize and treat pathophysiologic states from the lens of the venous system. Dr. Wise's overall goal of this pilot project is to robustly characterize the physiologic changes that occur in pigs upon induction of polymicrobial sepsis. Collaborators at Vanderbilt University developed an approach to quantifying severity of intravascular fluid depletion by non-invasive acquisition and interpretation of underappreciated waveforms, an approach called Non-Invasive Venous waveform Analysis (NIVA). Using a series of pigs with induced polymicrobial sepsis, a NIVA algorithm will be derived, tested and validated for states of distributive shock, such as sepsis. Additionally, fresh venous tissue samples will be taken from the hindlegs of these pigs, and suspended on a muscle bath. This will allow determination of the patterns of injury of vascular endothelial cells, smooth muscle cells and extracellular matrix. This work may predicate advances to the care of our patients with sepsis or similar conditions. Use of NIVA to gauge response to fluid therapy during resuscitation from sepsis represents a plausible and novel mode of hemodynamic monitoring, to avoid the clinical consequences of fluid overload. Moreover, the pattern of sepsis-induced injury that leads to pathologic vessel weakening ("vasoplegia") may inform more directed therapeutic strategies. This work is exciting, and allows us to take a clinical problem to the lab, and ultimately, improve patient care: the bench-to-bedside-to-bench paradigm that is so important in medicine. Our surgical patients can be very sick, and utilization of our laboratory-based skills to make a tangible impact is a prospect that drives his desire to do research, as a surgeon-scientist. Dr. Wise is excited to move forward with this work under the Translational Center for Resuscitative Trauma Care.

Kristin Colling, MD: “Pre-Hospital Care in a Rural Trauma Systems’ Effects on Outcomes in Traumatic Brain Injury.”

Kristin Colling MD FACS is a trauma, critical care surgeon and the trauma research director at Saint Mary’s Medical Center, a level 1 Trauma Center in Duluth, MN. Dr. Colling is an adjunct assistant professor with the University of Minnesota Surgery Department, and a member of the Translational Center for Resuscitative Trauma Research.  Her research focuses on rural trauma systems, including methods to improve pre-hospital care, improve equity of trauma care access, and studying special populations that are disproportionately represented in rural trauma, such as geriatric trauma. More than 1.2 million Minnesotans live in rural communities, and rural Minnesotans are at higher risk of death due to injury compared to urban residents. Rural car crashes in Minnesota have twice the fatality rate of urban crashes, and higher risk of traumatic brain injury. Traumatic brain injury is a leading cause of death and disability in Minnesota and the U.S, and early, goal-directed treatment has been proven to decrease secondary injury and improve patient outcomes in brain injury. Trauma systems facilitate earlier access to specialty trauma care for TBI through directed transfer to the specialized centers, and the goal of a successful trauma system is to provide access to trauma care in an equitable and efficient manner to its population. However, multiple socioeconomic groups continue to be at higher risk of TBI and death due to TBI, including the elderly, Native Americans, and rural Americans. While these rural/urban disparities are often reported, minimal research has looked at what the causes of these disparities are. The goal of Dr. Colling’s TCRTC Pilot Project is to identify these disparities and evaluate pre-hospital factors associated with worse outcomes after traumatic brain injury. Through this project, Dr. Colling will create a Geographic Informatic System (GIS) map of the rural trauma system that St. Mary’s serves, which will allow geographic visualization of the trauma system resources and injury location of traumatic brain injuries during the study period. The study will identify factors in pre-hospital care and trauma system infrastructure associated with outcomes after TBI, with the larger goal of identifying opportunities for improving rural trauma care in Minnesota.  This study is an important first step in addressing the inequities facing people injured in rural areas. Rural trauma systems face unique challenges not experienced by urban trauma systems, as trauma resources are scarce (e.g., fewer EMS providers and hospitals per capita) and resources are spread out over a wide area due to the less-dense patient population. Once we have a better understanding of where these areas of increased risk and resource scarcity overlap, we can implement novel interventions to address those risks, using telemedicine, targeted training, and modifications in transportation methods or coordination of care. This project will provide the necessary first steps to identify disparities in a single trauma system serving northern Minnesota, which can then be applied to Minnesota as a whole, improving trauma care and access for our entire population. Dr. Colling is driven to perform this research by her patients. She has seen firsthand how delays in access to trauma care affects her patients and community, and her long-term goal is to find solutions that will minimize disparities in trauma outcomes based solely on how far away you are from a trauma center.

Elizabeth Lusczek, PhD: “Toward Continuous Point-of-Care Monitoring of Succinate in Trauma Patients”

Beth Lusczek PhD, a physicist by training, is faculty in the Department of Surgery. She helped identify succinate as an acute biomarker of mortality from hemorrhagic shock while working as a graduate student in Greg Beilman’s lab.

A decade later, she is working with co-investigators Sarah Swisher, Phil Buhlmann, and Andreas Stein as they develop a wearable patch capable of continuously sensing succinate that can be used at the point of injury.

With the TCRTC pilot grant, the group will develop succinate-specific chemical receptors that will allow the patch to sense succinate. Currently, the group is creating a wearable potassium-sensing prototype patch with the support of the International Institute for Biosensing at the University of Minnesota. Because of the TCRTC grant, future iterations of the patch will also be able to sense succinate.

Continuous measurement of succinate has the potential to revolutionize triage of severely injured people, particularly in low-resource settings. Accurate and straightforward triage at the point of injury is essential to preventing death from hemorrhage. However, identification of those in need of intervention remains challenging since visual cues and vital signs do not always reflect injury severity and mortality. In order to improve triage and prevent death from hemorrhage, objective quantification of mortality risk is needed as quickly as possible. The wearable succinate sensing patch that is being developed can fill this gap.

Dr. Lusczek has envisioned outfitting first responders, ambulances, and military medics with small, fast succinate detectors for nearly a decade. The technology that co-investigators Buhlmann, Swisher, and Stein are creating can fulfill this vision, and she is honored to be part of the collaboration.

In her spare time, Dr. Lusczek enjoys reading and spending time outdoors.

2023 TCRTC Scholar Award Winner

We would like to congratulate our winner for 2023 TCRTC Scholar Award. If you are interested in becoming a Scholar, this program with a rolling deadline is still open and accepting applications! See our Funding Announcements Page for more information.

Sarah Knack, MD: "Sedation and Analgesia in Patients with Severe Traumatic Brain Injury and Risk of Shock"

Introduction: My name is Sarah Knack and I am an emergency physician working at Hennepin Healthcare and pursuing my Master’s degree in clinical research at the University of Minnesota.

What is the overall goal of your research? The overall goal of my research is to optimize the pre-hospital and emergency department care for patients with severe traumatic brain injury.

Briefly describe your TCRTC Pilot Project: My TCRTC pilot project focuses on the acute management of pain and sedation in patients with severe traumatic brain injury.  I plan to explore the impact of sedation and analgesic agents on both immediate hemodynamics and functional outcomes using pre-hospital and emergency department data.  Additionally, I plan to look for associations between agitation during the first few days of care and patient outcomes.

What will be the community and patient impact of this work? Although they are nearly ubiquitously used, there is currently very little data available regarding the effects of analgesics and sedatives on cerebral perfusion in this patient population.  This exploratory work has the potential to identify associations that will serve as the basis for future interventional work.  Ultimately the goal of this work is to prevent secondary brain injury from cerebral hypoperfusion and optimize outcomes for patient with severe traumatic brain injury.

Why are you driven to do this work? I completed my emergency medicine training at Hennepin County Medical Center and worked and had to make daily decisions about the management and care of this patient population.  I realized many of these decisions were based on anecdotal experience rather than high quality evidence and see an opportunity to advance knowledge in this field.

What do you like to do in your off-time? I currently live in Bloomington with my husband, 1 year old son, coonhound and two cats.  We enjoy outdoor activities such as our pool, local parks and the cabin in the summer and snowmobiling in the winter.  I also enjoy regular game nights with my coworkers.

 

mu

Volunteer Opportunities

This space will be used to promote Center and Center member volunteer opportunities.

Center members: Please email Amanda Hayward (haywa028@umn.edu) with any volunteer opportunities that you would like us to promote.