More than 200,000 people die in the United States from septic shock and hemorrhagic shock each year. Shock is defined medically as a condition of abnormally low blood pressure associated with poor blood flow to the tissues. It can result from physical damage (hemorrhagic shock) or from infection (septic shock). In shock, too little blood goes to vital organs, such as liver, kidney, intestine, and brain. This causes cellular damage, loss of function of organs, and, ultimately, death. Hemorrhagic shock is primarily caused by traumatic injury, from automobile accidents, bullet or knife wounds, and falls.

Trauma is the leading cause of death for people under 45 in the U.S. Septic shock results from the infection of tissues leading to the presence of bacteria or their products in the blood stream. It is the primary cause of death in intensive care units, and is a major problem for the elderly and for both children and adults with cancer.

The UMKC Shock Trauma Research Center is engaged in research to develop new treatment strategies to reduce the amount of cell death that occurs following shock. Besides studies in shock, the research programs of the Center include basic studies to understand the molecular events that allow cells of the immune system to “recognize” the presence of microbes and microbial products, and to communicate that information to white blood cells, whose job it is to kill the microbes and neutralize the toxins they produce. The Center is funded by more than $600K annually in research grant support from the National Institutes of Health, the Department of Defense, the Sosland Foundation, and other sources.

A major objective of the studies of hemorrhagic shock has been to develop new pharmacologic treatments. Current treatment for patients with hemorrhagic shock consists of fluid replacement coupled with strong supportive care to restore normal blood pressure, and surgical care to stop the blood loss and repair injuries. Unfortunately, this approach does not target the basic cause of cellular injury and organ damage. Significant advances in research during the past several decades, in part contributed by members of the Shock Trauma Research Center, have provided new insights into the basic molecular mechanisms that are responsible for the cellular injury and organ damage which result from shock.

Significant work is being done on defining the genomic response to shock. In an experimental model, a standard shock insult is treated with several different pharmacologic agents and/or nutrients, and the response of genes in white blood cells is measured. Similar genomic studies are being carried out in patients admitted to the Trauma Center of Truman Medical Center.

Treatment of the septic patient involves targeting the infectious agent with antibiotics and supportive care. Here again, advances over the last decades have greatly increased our understanding of the inflammatory reaction which is at the heart of septic shock. Scientists in the Center are exploring which of the various complex molecular events that occur in the host immune response to infection are the most important in producing the inflammatory mediators that cause blood vessels to become leaky. Researchers hope to use this information to design specific molecular inhibitors that will reduce this and, as a consequence, improve delivery of oxygen to vital tissues. Their efforts are intended to determine the molecular basis for these observations, as well as to develop drug regimens to improve patient care. The ultimate goal will be to design, develop, and implement therapies which can be used to treat patients with sepsis.

Activities of the Center: 

• Hemorrhagic shock

• Molecular and cellular immunology

• Translational and outcomes research

• Emergency medicine