Étude pilote de mesure de l'acide urique chez les patients traumatisés: déterminants et association pronostic

 

Emmanuel Charbonney

CIUSSS du Nord-de-l'Île-de-Montréal

 

Domaine : santé circulatoire et respiratoire

Programme Consortium pour le développement de la recherche en traumatologie - Volet 2

Concours 2018-2019

Dr. Charbonney proposes a project to explore the role of uric acid release (a molecule also responsible for gout) during severe trauma.

Severe trauma is the leading cause of death in people aged 15-40, with significant blood loss and brain damage leading to immediate mortality. However, those who survive this stage may develop organ failure, including secondary brain damage. This has consequences not only for their survival in the hospital, but also for their long-term health. After initial resuscitation, life support is continued in the intensive care unit. However, no specific intervention can treat the failing organs or help to better recover from the trauma. After tissue damage and initial bleeding, numerous molecules and activators of the defense system are released and lead to secondary lesions of an already traumatized organism.

Dr. Charbonney has demonstrated, in an animal model, that uric acid plays a role in the secondary inflammation of organs (kidneys, lungs) following hemorrhage and that it can be reversed by the destruction of uric acid.

The next step, which is the goal of this project, is to better understand the fluctuation of the level of uric acid in traumatized patients by making serial measurements during their hospitalization in the intensive care unit. In addition, the determinants (e.g. type of trauma, diseases, interventions) of the blood level of uric acid and its association with the development of organ failure will be sought.

The release of uric acid after trauma could represent a treatable / modifiable abnormality. This project will target the traumatized population at the right time, in order to develop an intervention lowering uric acid (already existing drug) and improve their recovery.