Getting answers

With research funded by the Department of Defense, two scientists have taken novel approaches with IV resuscitation fluids to find ways to save Soldiers' and civilians' lives.

Joseph Messina of the University of Alabama at Birmingham and Patrick Kochanek of the University of Pittsburgh don't collaborate with one another, but they both are interested in improving patients' chances of surviving trauma, be it on a battlefield or in a Buick.

"I want to take my basic science background and training and apply it to a problem that can help a lot of other people," Messina said.

As an undergraduate at Dartmouth College, Messina started working with the "master metabolic hormone" insulin, he said. He's been hooked ever since. Rather than focusing on diabetics, however, the endocrinologist has studied the effects injuries have on the body's insulin levels and how those levels in turn affect a patient's chance of surviving.

When a person hemorrhages or experiences major trauma, the body can undergo severe changes in its metabolism and immune system, like becoming resistant to insulin. This insulin resistance causes poor outcomes in critically ill patients. Messina's research focuses on reducing the amount of damage that's done to a body's organs during hemorrhage or trauma by using drugs that are commonly used by type 2 diabetics, who are also resistant to insulin.

"I asked myself where or when this would be most practical, and it occurred to me that it would be in situations outside of the ICU (intensive care unit). For instance, in the battlefield there would (be) the potential need for a treatment that would require less dependency on high-tech equipment," he said.

A graduate of the University of Michigan Medical School and the University of Virginia School of Medicine, Messina thought that drugs rather than insulin would be the better choice on the battlefield.

"These drugs are insulin sensitizing agents, and mo

Contact: Karen Fleming-Michael
US Department of Defense Congressionally Directed Medical Research Programs

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