Scientific priorities and strategic planning for resuscitation research and life saving therapy following traumatic injury: report of the PULSE Trauma Work Group.

Traumatic injury and its sequelae remain a major, unrecognized public health problem in North America. Traumatic injury is the principal cause of death in patients aged 1-44 years and the overall leading cause of life-years lost in the United States. Recognizing this, the National Heart, Lung, and Blood Institute (NHLBI), in conjunction with other federal agencies, organized a conference in June 2000 to discuss the basic and clinical research needs that could lead to improved outcomes following cardiopulmonary or post injury resuscitation. The Post Resuscitative and Initial Utility of Life Saving Efforts (PULSE) Workshop resulted and eight work groups were established to focus on various aspects, including organ systems, pharmacology, epidemiology, and trauma. The Trauma Work Group recommendations are presented in this article. Despite the recognition of improved survival and outcome through advancements in trauma systems and trauma care, the National Institutes of Health (NIH) support ratio for trauma research is only 0.10, compared with 1.65 for cancer research and a remarkable 3.51 for AIDS and HIV infection research. The successful federal HIV research program has significantly decreased the morbidity and mortality over the last ten years at a cost of $1.4 billion per year. A coordinated trauma research program should aim to replicate the success achieved by such programs; however, a centralized federal "home" for trauma research does not exist. Consequently, the existing limited research support is derived from NIH institutes in addition to other federal and state agencies. This report serves to describe some of the obstacles and outline various strategies and priorities for basic science, clinical, and translational trauma resuscitation research.