Modulation of Hemostasis and Metabolic Homeostasis to Treat Hemorrhagic Shock

Our objective is to develop a method to prevent death due to hemorrhage and shock. Hemorrhagic shock injury (HI) is a leading cause of death in people under the age of 45 and accounts for almost half of trauma-related deaths. Most of the death due to severe hemorrhage on the battlefield is preventable. Survival following severe blood loss can be improved by promoting hemostasis and restoring metabolic homeostasis. In this project, our focus is on the development of next-generation resuscitation and stabilization methods for prolonged field care. We propose that a combination drug therapy using niacin and tranexamic acid (NAC-TXA) will have salutary effect when used following severe hemorrhage, in prolonged field care. We expect that successful completion of the studies will lead to development of methods for stabilization of patients in the absence of resuscitation and during low volume resuscitation by a synergistic combinatorial therapy that will result in preservation of organ function for a protracted period of time leading to extended survival. This extension of survival en route from remote operating environment is expected to enable organ support and critical care in a distant medical facility preventing irreversible organ dysfunction or death. Our studies will demonstrate that agents that modulate metabolic homeostasis will be effective next-generation hemorrhage control adjuncts.