Under the leadership of Henry E. Wang, M.D., M.S., Professor and Vice Chair for Research, the UAB Department of Emergency Medicine maintains an active NIH-funded clinical research program focused on acute resuscitation and systems of emergency care delivery. The department maintains close collaborations with experts in cardiac arrest, trauma, sepsis, shock, resuscitation, stroke, heart disease, biostatistics, epidemiology, health services research, and disaster medicine.
The University of Alabama at Birmingham is one of America's premier research universities, ranking among the top 20 in funding from the National Institutes of Health and earning more than $470 million per year in extramural support. UAB is home to the University of Alabama at Birmingham School of Medicine and UAB Hospital, Alabama's major tertiary referral center and only Level I trauma center. With a world-renowned academic health center and 80 interdisciplinary research centers, UAB has a vibrant collaborative medical research community.
Below is a listing of major research grants and activities for the UAB Department of Emergency Medicine.
Supported by grant R01-NR012726 from the NIH-National Institute for Nursing Research, the UAB CCTS Translational Science Pilot Award, and the UAB Lister Hill Center for Health Policy Pilot Project Award.
Sepsis is a major public health problem resulting in over 500,000 Emergency Department visits, 750,000 hospital admissions, and 200,000 deaths in the US each year. Sepsis mortality also varies across the US, with a two-fold higher incidence of sepsis deaths in the Southeastern US. Despite the importance of this condition, the risk factors for sepsis remain unknown. This study will use the infrastructure of REGARDS, a national 30,000-subject population-based cohort funded by the National Institute of Neurological Diseases and Stroke. The objectives of the study are to identify the individual, family, community and societal/system healthcare factors associated with sepsis susceptibility and to determine their mediating effects on regional sepsis variations. In a parallel effort we are evaluating the relationship between baseline inflammatory and endothelial cell signal markers and sepsis susceptibility.
Resuscitation Outcomes Consortium (ROC)
Supported by grant U01-HL077881 from the National Heart, Lung, and Blood Institute in partnership with the National Institute of Neurological Disorders and Stroke, US Army Medical Research & Material Command, Canadian Institutes of Health Research–Institute of Circulatory and Respiratory Health, Defence Research and Development Canada, Heart and Stroke Foundation of Canada, and American Heart Association.
Since 2005, the Alabama Resuscitation Center has participated as one of the ten core sites of the Resuscitation Outcomes Consortium (ROC), a multicenter clinical trials network focused on research in the areas of prehospital cardiopulmonary resuscitation and severe traumatic injury. The focus on prehospital care and early hospitalization interventions recognizes the critical importance of this time frame and early congruence between the emergency cardiac and trauma populations. ROC is designed to conduct collaborative trials of various sizes and durations, equally distributed between cardiac and trauma populations, leveraging the combined power of the member institutions and promoting the rapid translation of promising scientific and clinical advances for the public good. To date, ROC has completed several important studies of cardiac arrest and trauma resuscitation and generated over 40 publications and hundreds of scientific presentations around the globe.
Funded through 2015, upcoming ROC trials include testing alternative strategies of continuous chest compressions, a clinical trial of amiodarone vs. lidocaine vs. placebo for ventricular fibrillation cardiac arrest, evaluation of point-of-care lactate in the evaluation of hemorrhagic shock, an evaluation of a strategy of permissive hypotension in hemorrhagic shock, and a comparison of blood product transfusion strategies in trauma.
Emergency Department Opt-Out HIV Testing
Supported by contract 9-UE-11 from the [Centers for Disease Control and Prevention and the Alabama Department of Public Health].
Approximately 220,000 individuals living in the U.S. are infected with HIV but do not know they are infected, leading to an estimated 56,000 new HIV transmissions annually. The CDC now recommends that hospitals and primary care clinics screen all patients between ages 18 and 65 for HIV to increase the number of individuals who are aware of their HIV-status. The DEM and UAB 1917 Clinic were recently awarded a three-year public health services contract ($1.6 million) sponsored by the CDC and Alabama Dept. of Public Health to provide free HIV testing to all adult ED patients. The project will link newly diagnosed cases to follow-up counseling and treatment services.
Protocolized Care for Early Severe Sepsis (ProCESS)
Supported by grants [P50]-GM076659 and [P50]-GM076659-04S1 from the NIH-National Institute for General Medical Sciences.
UAB is a participating center and the leading enrolling site for the Protocolized Care for Early Severe Sepsis (ProCESS) Trial. Led by the University of Pittsburgh, ProCESS is a randomized clinical trial comparing the effectiveness of three strategies for septic shock resuscitations: 1) Early Goal Directed Therapy, 2) Protocolized Standard Care, and 3) Standard Care. The study will also evaluate the biologic response to sepsis as well as the cost-effectiveness of the treatment strategies. A parallel study is evaluating endothelial cell signaling and microcirculatory flow in septic shock.
State Data Infrastructure for Prehospital and Hospital Comparative Effectiveness Research
Supported by grant R01-HS020097 from the Agency for Healthcare Research and Quality.
Spearheaded by Rutgers University Center for State Health Policy and the New Jersey Department of Health, this project seeks to create a data infrastructure for comparative effectiveness research (CER) by linking NJ statewide prehospital and hospital data. This project with evaluate the comparative effectiveness of therapeutic hypothermia for initial survivors of out-of-hospital cardiac arrest.