Improvements in the short-term outcomes after severe trauma achieved through early resuscitation may be off set in the medium term by acute inflammatory responses, leading to infection. This excess pro and anti-inflammatory environment in the body impairs the period of rehabilitation that the patient will be undergoing. Research from the SIRS Study has shown that a major circulating steroid precursor of sex hormones, Dehydroepiandrosterone (DHEA), and its stored form: DHEAS, are low immediately after injury. Patients who have undergone a trauma will be identified by members of the research team at the SRMRC. After seven days in intensive care, patients will have their usual levels of DHEA and DHEAS measured in the blood. On day 8, the patient will be randomly assigned to either receive a DHEA supplement to be placed under their tongue or to be swallowed. If the patient stays in hospital, they will consume the DHEA supplement for 2 more days to see if it has any beneficial effect upon the cells responsible for the immune response after injury.
The ADaPT trial aims to establish a dose of supplemental Dehydroepiandrosterone (DHEA) sufficient to raise circulating DHEA levels in severely injured trauma and hip fracture patients after up to 3 days of supplementation, to levels observed in healthy, young, adult, males.
Lt Col Mark Foster