Project 454967

Canadians who suffer from severe traumatic injuries are dying from bleeding and clotting defects because critical illness disrupts the body's natural clotting system. This process, called coagulopathy, is common and poorly understood, and is also a common cause of death and disability in Canadians who arrive to the emergency room with cardiac arrest, severe infections, and with COVID-19. Because we cannot predict whether patients will end up with predominantly bleeding defects or clotting defects, it is difficult to decide whom to treat with drugs that either prevent bleeding, or blood thinners to prevent clotting. We believe that that the body's response to injury and infection causes measurable molecules of inflammation and heightened blood clotting. Our approach aims to find these molecules to be used to identify patients that will require specific targeted treatment before they suffer from coagulopathy. To achieve this, we have assembled a collaborative effort between the largest intensive care hospital networks in Canada with the Thrombosis and Atherosclerosis Research Institute (TaARI), the largest and most comprehensive Canadian facility dedicated to the study of inflammation and blood clotting diseases. Our extensive infrastructure allows us prospectively collect blood samples from patients suffering from trauma, sepsis, cardiac arrest, and COVID-19. Using state-of-the-art methods developed by our group, we will measure biomarkers from the pathways that control inflammation, blood vessel integrity, clot formation, and clot breakdown. Using a machine learning algorithm recently published by our group, we plan to identify and compare which markers can predict coagulopathy in these diseases. By understanding how coagulopathy develops in the early stages of critical illnesses that commonly affect Canadians, we may be able to identify those patients requiring aggressive therapy earlier in the course of the disease.