I’m the director of the newly created NIH Office of Emergency Care Research (OECR), which is housed in NIGMS. For the past 11 years, I was an emergency medicine physician and clinical researcher. So you might be wondering why I’m writing a post for a blog primarily read by thousands of basic scientists. Don’t stop reading, though, because OECR and NIGMS-funded research have more in common than you might think. Let’s take a quick look at one area where basic and emergency medicine research interests converge—sepsis.
NIGMS supports both fundamental studies and clinical research on sepsis, including the PRoCESS (Protocolized Care for Early Septic Shock) clinical trial. This study is designed to determine if early intervention with rigorous, standardized care in sepsis and septic shock can improve clinical outcomes. It’s an astonishingly important effort to address a disease that often presents to the emergency department and that has a mortality rate of about 30 percent. Should the study demonstrate improved outcomes, it will change the care of some 750,000 Americans who develop sepsis each year.
In addition to sepsis, NIGMS funds research in other areas relevant to emergency medicine, including trauma, burn injury, wound healing, and anesthesia.
I’m committed to helping all parts of NIH improve outcomes for patients in need of emergency treatment, and stepping into the OECR position is allowing me to focus on the national challenges that face emergency medicine research. Toward this end, OECR has four objectives:
- To develop and refine NIH’s existing research portfolios in emergency care;
- To coordinate research projects that involve multiple NIH components;
- To create ways to fund new research that impacts patients with time-sensitive medical conditions; and
- To promote the training of the next generation of emergency care researchers.
It’s a big mission for a small office, but we are fortunate to have many energetic partners across NIGMS, NIH and the broader community.
Whether you’re a basic scientist or a clinician, the ultimate goals are the same, so I welcome your interest in and input on OECR activities.
This PRoCESS is interesting, but how do the clinicians know when early intervention is needed? My understanding is that clinical indicators are poor for predicting outcome for patients. Furthermore, what early interventions? Pretty much all of the clinical trials have failed. IV Vitamin C will require administration before the patient has significant oxidative stress. At that point, it will likely be too late. Hence, without early biomarkers of septic stages and new interventions (both seem to be lacking at this time as well as combinatorial approaches), PRoCESS seems somewhat premature at this time from just reading this blog. Maybe an RFA for new ideas from investigators outside the sepsis field (new perspectives on the problem) may be a good idea.