VCU Biological Complexity

Equipping a Large Animal Intensive Care Unit for the Study of Combat
Casualty Care Related Trauma and Multisystem Organ Failure:

Kevin R. Ward, MD
Principal Investigator: Departments of Emergency Medicine and Physiology

R. Wayne Barbee, PhD
Co-Investigator: Departments of Emergency Medicine and Physiology

Rao R. Ivatury, MD
Co-Investigator: Departments of Surgery and Emergency Medicine

Award Amount: $ 354,000

This grant will allow for the purchase of monitoring, diagnostic and treatment equipment to develop a 2-bed large animal stand alone intensive unit. The unit is designed to develop models of acute combat
casualty care injury and illness that lead to the development of multisystem organ failure (MOF). The unit will contain all of the modern equipment found in a clinical intensive care unit including x-ray, and
blood chemistry and gas analysis capabilities. Additionally, state of the art equipment will be purchased allowing for multiorgan system monitoring and analysis of the microcirculatory system and oxygen transport. "This grant will allow us to create one of the most technologically sophisticated animal ICU systems in the world," says VCURES associate director Kevin Ward. He states further that "There are
few good models of trauma or infectious induced multisystem organ failure because of the limited number of facilities having the technology and know-how to provide animals intensive supportive care for days which are necessary to see the occurrence of MOF resulting from the initial injury or illness. Many of the things we do as a part of treatment of acute illness and injury such as mechanical ventilation and blood transfusions to keep people alive are now being shown to be a double edged sword and may contribute to the development of sepsis and MOF. Inclusion of this degree of clinically relevant supportive care in animal models is critical to developing a holistic understanding of how
the disease develops and to determine at what points we can intervene to improve outcome. The improvements in combat casualty care coupled with the changing nature of combat operations means that we will be saving more of our military personnel initially but evacuation and transport
times may be significantly increased meaning the wounded will be much more at risk for subsequent complications such as sepsis and MOF. The ICU will provide VCURES an incredible opportunity to examine the complex longitudinal and parallel changes that occur from the level of the gene
and protein to the microvasculature to traditional hemodynamic manifestations. This in turn will assist our effort in creating computational models of complex injury and disease patterns." The ICU is
a vital part of two VCURES programs including its Operation Purple Heart with its focus on Combat Casualty Care ( http://www.vcu.edu/vcures/purpleheart.htm ) and its Biocomplexity and Computational Medicine Program for Trauma and Sepsis in which it partners with the VCU Center for the Study of Biologic Complexity ( http://www.vcu.edu/csbc/). The grant will assist in learning to translate findings rapidly between the laboratory ICU and the clinical ICU. The information gained will also greatly enhance our potential to treat civilian victims of trauma, sepsis, and MOF.