Resuscitative Endocrinology: Single-dose Clinical Uses for Estrogen - Traumatic Hemorrhagic Shock (RESCUE - Shock)

Annually in the United States, approximately 30 million people require treatment for
traumatic injuries in emergency departments. Two million of these patients require
hospitalization, with several hundred thousand ultimately dying, often due to extreme blood
loss. Importantly, these traumatic injuries are the leading cause of death and disability for
children and young adults under the age of 44, with the total cost of trauma in the U.S.
approaching $260 billion each year.

Despite advances in pre-hospital care, early resuscitation, surgical interventions and
intensive care monitoring aimed at the primary traumatic injury, many survivors never
recover. A significant cause of this mortality and morbidity is thought due to potentially
preventable secondary injury, namely oxidant injury, inflammation, and apoptosis beginning in
the first few hours after the severe traumatic event.

In spite of the current bleak outlook for many of these patients, a series of animal
investigations have uncovered a promising solution to the problem of the secondary injury
seen in hemorrhagic shock and other similar processes, namely the early administration of
estrogen, a strong anti-oxidant, anti-inflammatory and anti-apoptotic compound. Based on
these encouraging results from animal studies, the investigators hypothesize that early
administration of IV Premarin® in patients with hemorrhagic shock will safely reduce
secondary injury, and improve survival.