Post-traumatic coagulopathy in injured children.

My research group has utilized clinical data to define and better understand post-traumatic coagulopathy in injured children.  We have established the relationship between abnormalities in conventional clotting assays and mortality and have used results of viscoelastic testing to define specific domains of the clotting mechanism most closely associated with mortality as well as the kinetics of the response.  We are also examining components of the “endotheliopathy” of trauma and the relationship between markers of endothelial dysfunction and poor outcome in injured children.

Hemorrhagic shock and the role of cold-stored whole blood for resuscitation of injured children.

I have been active among pediatric trauma leaders in identifying hemorrhagic shock as an area that is understudied and in need of additional research attention.  As part of that work, our group was the first to publish on the use of cold-stored, leukocyte-reduced group O negative whole blood for the initial resuscitation of injured children.  We have established that the product is safe and efficient, and our outcome data suggests a more rapid recovery from shock and that there is a potential survival advantage for injured children requiring a massive transfusion.  This data is informed the development of the large, federally funded study evaluating whole blood vs. components for resuscitation.  We also studying issues related to Rh incompatibility in whole blood, as well as whole blood usage in other types of massive hemorrhage.

General pediatric trauma and injury prevention

Trauma is the leading cause of death in children, and a significant number of injuries are potentially preventable.  We have studied primary prevention interventions, such as the utility of a mobile safety center and bike helmets, abusive injuries as compared to those incurred accidentally, and other topics of general pediatric trauma interest.