Karim Brohi

Karim Brohi

Title: Professor
FRCS FRCA
Professor of Trauma Sciences

Karim Brohi is Head of the LondonTIER, Professor of Trauma Sciences in the Blizard Institute, Barts and the London School of Medicine & Dentistry, and Consultant Trauma & Vascular Surgeon at Barts Health NHS Trust. He is also director of the North East London & Essex Trauma Network.

Personal website: trauma.org

Research

Themes: Experimental Medicine (lead)

Karim Brohi is Professor of Trauma Sciences at Queen Mary, University of London and Consultant Vascular & Trauma Surgeon at Barts Health NHS Trust. The Royal London Hospital is the United Kingdom's flagship Major Trauma Centre and home to both civilian and military partners, all committed to maximising the impact of research and education in Trauma Sciences. Prof Brohi’s research interests cover the breadth of trauma sciences - from the acute damage response of the body to trauma, through all phases of trauma care from pre-hospital to rehabilitation and health services research. Fundamental research activity focuses upon trauma-associated coagulopathy (i.e. clotting abnormalities) & massive transfusion, trauma patient outcomes, systems biology and complexity analysis of trauma critical care.

Recent and ongoing research projects

Activation of Coagulation and Inflammation in Trauma (ACIT)
Founded upon his initial observation that an Acute Traumatic Coagulopathy can present within minutes of injury, ACIT is designed to identify the clinically significant mechanisms and pathways by which inflammation and coagulation are activated immediately following major trauma, and the observed clinical consequences of this in terms of bleeding, transfusion requirements, organ injury, multiple organ failure and death. The study continues to be supported by commercial partnership and has been now recruits in several major trauma centres across Europe and the USA.

Traumatic Coagulopathy and Massive Transfusion; Improving Outcomes and Saving Blood.
This 5-year NIHR-sponsored program of study has the overall objectives to enable the early identification of trauma-induced coagulopathy, the definition of the United Kingdom’s national instance of trauma hemorrhage and current patterns of transfusion therapy, and their associated outcomes and health economic impact. As well as gathering prospective data from a network of 22 hospitals over a period of 2-years, the study ultimately aims to identify the optimum methods to guide therapy and rationalise blood product administration during trauma haemorrhage and mass casualty events.

Trauma Outcomes Core Facility.
Sponsored by Barts and The London Charity, the principal aim of this 3-year project is to develop the world’s first dedicated Trauma Outcomes facility to explore and validate measures of trauma outcomes and to facilitate clinical and translational research across within the hospital and with other healthcare and academic institutes. The group is collecting long-term outcome data on trauma patients and conducting two pilot studies to demonstrate the power and potential of a fully-functioning facility. These two studies aim to 1) investigate cardiac outcomes following severe Trauma and 2) develop validated process of care benchmarks that are associated with improved outcomes to ensure quality and performance improvement of a regional trauma system.
 

Publications

Key Publications

Functional definition and characterization of acute traumatic coagulopathy.
Davenport R, Manson J, De’Ath H, Platton S, Coates A, Allard S, Hart D, Pearse R, Pasi KJ, Maccallum P, Stanworth S, Brohi K.
Crit. Care. Med. 2011 Jul 10.

Definition and drivers of acute traumatic coagulopathy: clinical and experimental investigations.
Frith D, Goslings JC, Gaarder C, Maegele M, Cohen MJ, Johansson PI, Stanworth S, Thiemermann C, Brohi K.
J Thromb Haemost. 2010 Jun 10.

A major trauma centre is a specialty hospital not a hospital of specialties.
Davenport RA, Tai N, West A, Bouamra O, Aylwin C, Woodford M, McGinley A, Lecky F, Walsh MS, Brohi K.
Br J Surg. 2010;97:109-17.

Circulating mitochondrial DAMPs cause inflammatory responses to injury.
Zhang Q, Raoof M, Chen Y, Sumi Y, Sursal T, Junger W, Brohi K, Itagaki K, Hauser CJ.
Nature. 2010;464:104-7.

All publications from PubLists

Adams A, Fotiadis N, Chin JY et al. (2012). A pictorial review of traumatic pericardial injuries.. Insights Imaging Vol.3, (4) 307-311.
10.1007/s13244-012-0177-9
Perkins ZB, De'ath HD, Aylwin C et al. (2012). Epidemiology and outcome of vascular trauma at a british major trauma centre.. Eur J Vasc Endovasc Surg Vol.44, (2) 203-209.
10.1016/j.ejvs.2012.05.013
Rourke C, Curry N, Khan S et al. (2012). Fibrinogen levels during trauma hemorrhage, response to replacement therapy, and association with patient outcomes.. J Thromb Haemost Vol.10, (7) 1342-1351.
10.1111/j.1538-7836.2012.04752.x
De'Ath HD, Rourke C, Davenport R et al. (2012). Clinical and biomarker profile of trauma-induced secondary cardiac injury.. Br J Surg Vol.99, (6) 789-797.
10.1002/bjs.8728
Frith D, Cohen MJ, Brohi K (2012). Animal models of trauma-induced coagulopathy.. Thromb Res Vol.129, (5) 551-556.
10.1016/j.thromres.2011.11.053
Frith D, Davenport R, Brohi K (2012). Acute traumatic coagulopathy.. Curr Opin Anaesthesiol Vol.25, (2) 229-234.
10.1097/ACO.0b013e3283509675
Cohen MJ, Call M, Nelson M et al. (2012). Critical role of activated protein C in early coagulopathy and later organ failure, infection and death in trauma patients.. Ann Surg Vol.255, (2) 379-385.
10.1097/SLA.0b013e318235d9e6
Fuller G, Bouamra O, Woodford M et al. (2012). Recent massive blood transfusion practice in England and Wales: view from a trauma registry.. Emerg Med J Vol.29, (2) 118-123.
10.1136/emj.2010.104349
Brohi K (2012). A strategy for future trauma research.. Br J Surg Vol.99 Suppl 1, () 4-5.
10.1002/bjs.7791
Manson J, Thiemermann C, Brohi K (2012). Trauma alarmins as activators of damage-induced inflammation.. Br J Surg Vol.99 Suppl 1, () 12-20.
10.1002/bjs.7717
Davenport R, Manson J, De'Ath H et al. (2011). Functional definition and characterization of acute traumatic coagulopathy.. Crit Care Med Vol.39, (12) 2652-2658.
10.1097/CCM.0b013e3182281af5
Hoffman K, West A, Nott P et al. (2011). Measuring acute rehabilitation needs in trauma: Preliminary evaluation of the Rehabilitation Complexity Scale.. Injury Vol., () -.
10.1016/j.injury.2011.11.001
Cole EM, West A, Davenport R et al. (2011). Can residents be effective trauma team leaders in a major trauma centre?. Injury Vol., () -.
10.1016/j.injury.2011.09.020
Brohi K, Cole E, Hoffman K (2011). Improving outcomes in the early phases after major trauma.. Curr Opin Crit Care Vol.17, (5) 515-519.
10.1097/MCC.0b013e32834a9353
Brohi K (2011). Prediction of acute traumatic coagulopathy and massive transfusion - Is this the best we can do?. Resuscitation Vol.82, (9) 1128-1129.
10.1016/j.resuscitation.2011.06.022
Davenport R, Rourke C, Manson J et al. (2011). Activated protein C is a principle mediator of acute traumatic coagulopathy. J THROMB HAEMOST Vol.9, () 1538-7933 51-52.
Rourke C, Curry NS, Khan S et al. (2011). Characterization of fibrinogen depletion and response to replacement therapy in bleeding trauma patients. J THROMB HAEMOST Vol.9, () 1538-7933 121-121.
Curry N, Stanworth S, Hopewell S et al. (2011). Trauma-Induced Coagulopathy-A Review of the Systematic Reviews: Is There Sufficient Evidence to Guide Clinical Transfusion Practice?. TRANSFUS MED REV Vol.25, (3) 0887-7963 217-231.
10.1016/j.tmrv.2011.01.001
Roberts I, Shakur H, Afolabi A et al. (2011). The importance of early treatment with tranexamic acid in bleeding trauma patients: an exploratory analysis of the CRASH-2 randomised controlled trial. LANCET Vol.377, (9771) 0140-6736 1096-1101.
10.1016/S0140-6736(11)60278-X
Manson J, Davenport R, Coates A et al. (2011). DEMONSTRATING THE HUMAN CYTOKINE RESPONSE TO TISSUE DAMAGE AFTER TRAUMATIC INJURY. SHOCK Vol.36, () 1073-2322 23-23.
Frith D, Baptista ML, Cohen MJ et al. (2011). EXPERIMENTAL ACUTE TRAUMATIC COAGULOPATHY: INITIATED BY HYPOPERFUSION, MODULATED BY THE PROTEIN C PATHWAY. SHOCK Vol.36, () 1073-2322 16-17.
Davenport R, Curry N, Manson J et al. (2011). Hemostatic effects of fresh frozen plasma may be maximal at red cell ratios of 1:2.. J Trauma Vol.70, (1) 90-95.
10.1097/TA.0b013e318202e486
Chana MS, Manson J, Davenport R et al. (2011). TIME COURSE OF LACTATE CLEARANCE IN TRAUMA AND ITS RELEVANCE TO OUTCOMES. SHOCK Vol.36, () 1073-2322 10-11.
De'Ath H, Manson J, Rourke C et al. (2011). TRAUMA INDUCED SECONDARY CARDIAC INJURY IS ASSOCIATED WITH ACUTE INFLAMMATION. SHOCK Vol.36, () 1073-2322 12-12.
Curry N, Hopewell S, Doree C et al. (2011). The acute management of trauma hemorrhage: a systematic review of randomized controlled trials. CRIT CARE Vol.15, (2) 1466-609X -.
10.1186/cc10096
Frith D, Stanworth S, Gaarder C et al. (2010). Acute traumatic coagulopathy is dependent upon injury load and shock. BRITISH JOURNAL OF SURGERY Vol.97, () 0007-1323 39-40.
Duchesne JC, McSwain NE, Cotton BA et al. (2010). Damage control resuscitation: the new face of damage control.. J Trauma Vol.69, (4) 976-990.
10.1097/TA.0b013e3181f2abc9
Frith D, Goslings JC, Gaarder C et al. (2010). Definition and drivers of acute traumatic coagulopathy: clinical and experimental investigations.. J Thromb Haemost Vol.8, (9) 1919-1925.
10.1111/j.1538-7836.2010.03945.x
Frith D, Brohi K (2010). The acute coagulopathy of trauma shock: clinical relevance.. Surgeon Vol.8, (3) 1479-666X 159-163.
10.1016/j.surge.2009.10.022
Zhang Q, Raoof M, Chen Y et al. (2010). Circulating mitochondrial DAMPs cause inflammatory responses to injury.. Nature Vol.464, (7285) 104-107.
10.1038/nature08780
Davenport RA, Tai N, West A et al. (2010). A major trauma centre is a specialty hospital not a hospital of specialties.. Br J Surg Vol.97, (1) 109-117.
10.1002/bjs.6806
Bouillon B, Brohi K, Hess JR et al. (2010). Educational initiative on critical bleeding in trauma: Chicago, July 11-13, 2008.. J Trauma Vol.68, (1) 225-230.
10.1097/TA.0b013e3181c42815
Stanworth SJ, Morris TP, Gaarder C et al. (2010). Reappraising the concept of massive transfusion in trauma. CRIT CARE Vol.14, (6) 1466-609X -.
10.1186/cc9394
Chesebro BB, Rahn P, Carles M et al. (2009). Increase in activated protein C mediates acute traumatic coagulopathy in mice.. Shock Vol.32, (6) 659-665.
10.1097/SHK.0b013e3181a5a632
Brohi K (2009). Trauma induced coagulopathy.. J R Army Med Corps Vol.155, (4) 0035-8665 320-322.
Brohi K (2009). Diagnosis and management of coagulopathy after major trauma.. Br J Surg Vol.96, (9) 963-964.
10.1002/bjs.6691
Bent CL, Fotiadis N, Renfrew I et al. (2009). Total percutaneous aortic repair: midterm outcomes.. Cardiovasc Intervent Radiol Vol.32, (3) 449-454.
10.1007/s00270-009-9537-3
Davenport RA, Brohi K (2009). Coagulopathy in trauma patients: importance of thrombocyte function?. Curr Opin Anaesthesiol Vol.22, (2) 261-266.
10.1097/ACO.0b013e328325a6d9
Cohen MJ, Brohi K, Calfee CS et al. (2009). Early release of high mobility group box nuclear protein 1 after severe trauma in humans: role of injury severity and tissue hypoperfusion. CRIT CARE Vol.13, (6) 1466-609X -.
10.1186/cc8152
Durai R, Agrawal R, Piper K et al. (2009). Wegener's granulomatosis presenting as an abdominal aortic aneurysm: a case report.. Cases J Vol.2, () 9346-.
10.1186/1757-1626-2-9346
Hess JR, Brohi K, Dutton RP et al. (2008). The Coagulopathy of Trauma: A Review of Mechanisms. J TRAUMA Vol.65, (4) 0022-5282 748-754.
10.1097/TA.0b013e181877a9c
Parr MJ, Bouillon B, Brohi K et al. (2008). Traumatic Coagulopathy: Where are the Good Experimental Models?. J TRAUMA Vol.65, (4) 0022-5282 766-771.
10.1097/TA.0b013e31818606d2
Kortbeek JB, Al Turki SA, Ali J et al. (2008). Advanced Trauma Life Support, 8th edition, the evidence for change. J TRAUMA Vol.64, (6) 0022-5282 1638-1650.
10.1097/TA.0b013e3181744b03
Ganter MT, Cohen MJ, Brohi K et al. (2008). Angiopoietin-2, marker and mediator of endothelial activation with prognostic significance early after trauma?. ANN SURG Vol.247, (2) 0003-4932 320-326.
10.1097/SLA.0b013e318162d616
Aylwin CJ, Brohi K, Davies GD et al. (2008). Pre-hospital and in-hospital thoracostomy: indications and complications.. Ann R Coll Surg Engl Vol.90, (1) 54-57.
10.1308/003588408X242286
Brohi K (2008). The Utstein template for uniform reporting of data following major trauma: a valuable tool for establishing a pan-European dataset.. Scand J Trauma Resusc Emerg Med Vol.16, () 8-.
10.1186/1757-7241-16-8
Brohi K, Cohen MJ, Davenport RA (2007). Acute coagulopathy of trauma: mechanism, identification and effect.. Curr Opin Crit Care Vol.13, (6) 1070-5295 680-685.
10.1097/MCC.0b013e3282f1e78f
Bent CL, Matson MB, Sobeh M et al. (2007). Endovascular management of acute blunt traumatic thoracic aortic injury: a single center experience.. J Vasc Surg Vol.46, (5) 0741-5214 920-927.
10.1016/j.jvs.2007.07.032
Ganter MT, Brohi K, Cohen MJ et al. (2007). Role of the alternative pathway in the early complement activation following major trauma. SHOCK Vol.28, (1) 1073-2322 29-34.
10.1097/shk.0b013e3180342439
Brohi K (2007). Trauma specialist centres. ANN ROY COLL SURG Vol.89, (5) 0035-8843 252-253.
10.1308/147363507x216681
Brohi K, Cohen MJ, Ganter MT et al. (2007). Acute traumatic coagulopathy: Initiated by hypoperfusion - Modulated through the protein C pathway?. ANN SURG Vol.245, (5) 0003-4932 812-818.
10.1097/01.sla.0000256862.79374.31
Aylwin CJ, König TC, Brennan NW et al. (2006). Reduction in critical mortality in urban mass casualty incidents: analysis of triage, surge, and resource use after the London bombings on July 7, 2005.. Lancet Vol.368, (9554) 2219-2225.
10.1016/S0140-6736(06)69896-6
Brohi K, Healy M, Fotheringham T et al. (2005). Helical computed tomographic scanning for the evaluation of the cervical spine in the unconscious, intubated trauma patient.. J Trauma Vol.58, (5) 0022-5282 897-901.
Brohi K, Singh J, Heron M et al. (2003). Acute traumatic coagulopathy. J TRAUMA Vol.54, (6) 0022-5282 1127-1130.
10.1097/01.TA.0000069184.82147.06
Walsh M, Brohi K, Cord-Udy C (2003). Splenectomy after major trauma: could more spleens be saved?. ANN ROY COLL SURG Vol.85, (3) 0035-8843 221-222.

Teaching

MSc Trauma Science
MSc Trauma Sciences Military & Austere Trauma

In 2011 Barts and the London School of Medicine, Queen Mary University of London; TRAUMA.ORG and the Royal College of Surgeons of England launched two innovative MSc programmes - A Masters in Trauma Sciences and a Masters in Trauma Sciences (Military & Austere).

These international Masters programmes are delivered in a modern e-learning environment as part-time distance-learning courses over two years. The course is tailored to the needs of international graduates from all healthcare and health sciences backgrounds, to provide high-quality learning no matter where you are in the world, and to develop the leaders of the future in the science and practice of trauma.

Topics for PhD supervision:

Trauma-associated: Coagulopathy; Massive Transfusion; Inflammation; Systems biology and complexity analysis; Patient Outcomes; Health services research.

PhD Students:

“Acute Traumatic Coagulopathy: Functional characterisation of the Protein C pathway & haemostatic response to transfusion” - Ross Davenport (2011)

“Clinical & experimental characterisation of Acute Traumatic Coagulopathy”–
Dan Frith (2011)

Further information

Professor Brohi founded the trauma.org web site and the ‘Trauma-list’ international discussion group in 1995 to provide free, open access trauma education and information to doctors and other healthcare providers around the world, and to provide a community forum for consultations and advice on patient care and current practice. TRAUMA.ORG was one of the first medical web sites on the Internet and is currently the largest and most active specialty medical web site, providing a continuous international forum for the discussion of trauma care issues and for global trauma consultation.

Contact

Aneesa Dickisosn
PA to Professor Karim Brohi
Trauma Clinical Academic Unit
2nd Floor West Wing
The Royal London Hospital
Whitechapel
London
E1 1BB

Tel: 020 7377 7000 (ext 2165, 7370)
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Professor Karim Brohi
Centre for Neuroscience and Trauma
Blizard Institute
Barts and The London School of Medicine and Dentistry
Blizard Building
4 Newark Street
London
E1 2AT

020 7377 7044
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