Critical Care Illness and Injury - Presented at the Fourth Annual Barsan Emergency Medicine Research Forum

1. Hakam Tiba, MD, MS
Emergency Medicine
MCIRCC
Pre-Clinical Modeling for
Critical Care Illness and Injury
Barsan Emergency Medicine Research Forum, Ann Arbor. 4/10/2019

2. Disclosure
o Invention disclosure (7206).
o Provisional patent application (62/506,971) Submitted May 16, 2017.
o Impedance prototype developed by In2Being, LLC.
o Impedance technology licensed to New Vital Signs, Inc.
o Funding
–DoD
–MICHR Synergy award
–Massey Family Foundation
–NIH
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3. Reflection
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“All models are wrong;
some models are useful.”
“The most that can be expected from
any model is that it can supply a
useful approximation to reality:”
George Box
1919 – 2013

4. Why Animal Modeling?
• Similar physiology and susceptible
to same diseases
• Genetic similarities
• Pharmacokinetics and toxicity
testing
• Study of early development and
progression of critical care disease
• Sequential and longitudinal
sampling of blood and tissue
• Therapeutics, diagnostics, and
markers
Replace
Reduce
Refine
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5. Large Animal Core (LAC)
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Dr. Ward
Director of MCIRCC
Hakam
Director of LAC
Brendan
Assistant Director of LAC
Carmen
Lab Manager
Brandon
Data Guru
Nick
The Rookie
Dani
S. Res. Assistant
Anne Marie
S. Res. Assistant

6. LAC Description
6
8
>$4,000.000
26
32
Abstracts
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7. Collaboration and Teaching
Collaboration
 More than 20 collaborators
 More than 10 departments
 Institutional and national
Teaching and Mentoring
 UROP
 ULAM residents
 Biomedical Engineering Students
 SBRP
 Capstone Project
 Fellows training
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8. Projects
 Cardiac arrest: CPR Models
 Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA)
 Valproic Acid (VPA)
 Epinephrine: bolus vs. continuous infusion trial
 Traumatic Brain Injury (TBI) Model
 Trans-ocular Brain Impedance (TOBI)
 Sepsis and ARDS Models
 Hemorrhage and Resuscitation Models
 Gastric Resuscitative Occlusion of the Aorta (GROA)
 Redox/metabolomics
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9. REBOA
Coronary Perfusion Pressure
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10. VPA and Neuroprotection
Coronary Perfusion Pressure Lactate
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11. Epinephrine, Bolus vs. Continuous Infusion
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12. Trans-ocular Brain Impedance (TOBI)
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13. Sepsis
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Cytokine concentrations over 12 hours of monitoring. TNF-α reached
peak(SD) concentration of 3.36x104(3x103) pg/mL at 1 hour after E. coli
inoculation. IL-6 reached peak(SD) concentration of 4.26x104(4.8x103)
pg/mL at 3 hours after E. Coli inoculation.

14. ARDS
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15. Gastric Resuscitative Occlusion of the Aorta
(GROA)
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16. Redox Potential vs. Blood Metabolites
Arterial Blood Mixed Venous Blood
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17. 17
THANK YOU!