Scott Brakenridge, MD, MSCS, FACS

(352) 265-0535

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Publications

Severe immunosuppression and not a cytokine storm characterize COVID-19 infections
JCI Insight
2020

Phenotypic heterogeneity by site of infection in surgical sepsis: a prospective longitudinal study
Critical Care
2020

Persistently increased cell-free DNA concentrations only modestly contribute to outcome and host response in sepsis survivors with chronic critical illness
Surgery
2020

Older Sepsis Survivors Suffer Persistent Disability Burden and Poor Long-Term Survival
Journal of the American Geriatrics Society
2020

Identification of Unique mRNA and miRNA Expression Patterns in Bone Marrow Hematopoietic Stem and Progenitor Cells After Trauma in Older Adults
Frontiers in Immunology
2020

Abdominal sepsis patients have a high incidence of chronic critical illness with dismal long-term outcomes
American Journal of Surgery
2020

Trauma Surgeon and Palliative Care Physician Attitudes Regarding Goals-of-Care Delineation for Injured Geriatric Patients
The American Journal Of Hospice & Palliative Care
2019

The Development of Chronic Critical Illness Determines Physical Function, Quality of Life, and Long-Term Survival Among Early Survivors of Sepsis in Surgical ICUs
Critical Care Medicine
2019

Immune checkpoint inhibition in sepsis: a Phase 1b randomized study to evaluate the safety, tolerability, pharmacokinetics, and pharmacodynamics of nivolumab
Intensive Care Medicine
2019

Immune Checkpoint Inhibition in Sepsis: A Phase 1b Randomized, Placebo-Controlled, Single Ascending Dose Study of Antiprogrammed Cell Death-Ligand 1 Antibody (BMS-936559)
Critical Care Medicine
2019

Current Epidemiology of Surgical Sepsis: Discordance Between Inpatient Mortality and 1-year Outcomes.

2019

Variations in institutional review board processes and consent requirements for trauma research: an EAST multicenter survey.
Trauma Surgery & Acute Care Open
2018

The Post-injury Inflammatory State and the Bone Marrow Response to Anemia.
American Journal of Respiratory and Critical Care Medicine
2018

The Impact of Prior Laparotomy and Intra-abdominal Adhesions on Bowel and Mesenteric Injury Following Blunt Abdominal Trauma.
World Journal of Surgery
2018

The Effects of Beta Blockade and Clonidine on Persistent Injury-Associated Anemia
Journal of Surgical Research
2018

THE IMPACT OF AGE ON THE INNATE IMMUNE RESPONSE AND OUTCOMES AFTER SEVERE SEPSIS/SEPTIC SHOCK IN TRAUMA AND SURGICAL INTENSIVE CARE UNIT PATIENTS.
Journal of Trauma and Acute Care Surgery
2018

Successful Nonoperative Management of Uncomplicated Appendicitis: Predictors and Outcomes

2018

Sepsis is associated with reduced spontaneous neutrophil migration velocity in human adults.
PLoS One
2018

Resuscitative Endovascular Balloon Occlusion of the Aorta: Implementation and Preliminary Results at An Academic Level I Trauma Center

2018

Persistent Injury-Associated Anemia in Aged Rats
Experimental Gerontology
2018

Persistent Injury-Associated Anemia and Aging: Novel Insights
Journal of Trauma and Acute Care Surgery
2018

Innate Immunity in the Persistent Inflammation, Immunosuppression, and Catabolism Syndrome and Its Implications for Therapy.
Frontiers in Immunology
2018

Hypertonic saline resuscitation after emergent laparotomy and temporary abdominal closure
Journal of Trauma and Acute Care Surgery
2018

Evidence for persistent immune suppression in patients who develop chronic critical illness after sepsis
Shock
2018

Effect of Time to Operation on Value of Care in Acute Care Surgery
World Journal of Surgery
2018

Chronic Critical Illness: Application of what we know
Nutrition in Clinical Practice
2018

Chronic Critical Illness and the Persistent Inflammation, Immunosuppression, and Catabolism Syndrome.
Frontiers in Immunology
2018

Burn Surgeon and Palliative Care Physician Attitudes Regarding Goals of Care Delineation for Burned Geriatric Patients.
Journal of burn care & research : official publication of the American Burn Association
2018

Benchmarking clinical outcomes and the immunocatabolic phenotype of chronic critical illness after sepsis in surgical intensive care unit patients
Journal of Trauma and Acute Care Surgery
2018

Anemia and Blood Transfusion in Elderly Trauma Patients
Journal of Surgical Research
2018

The epidemiology of chronic critical illness after severe traumatic injury at two Level One Tr
Critical Care Medicine
2017

Temporary Abdominal Closure for Trauma and Intra-Abdominal Sepsis: Different Patients, Different Outcomes
Journal of Trauma and Acute Care Surgery
2017

Sepsis and Critical Illness Research Center Investigators: protocols and standard operating procedures for a prospective cohort study of sepsis in critically ill surgical patients
BMJ Open
2017

Sepsis Pathophysiology, Chronic Critical Illness, and Persistent Inflammation-Immunosuppression and Catabolism Syndrome
Critical Care Medicine
2017

Routine Surveillance Cholangiography After Percutaneous Cholecystostomy Delays Drain Removal and Cholecystectomy
Journal of Trauma and Acute Care Surgery
2017

Human Myeloid-Derived Suppressor Cells Are Associated With Chronic Immune Suppression After Severe Sepsis/Septic Shock

2017

Early Bronchoalveolar Lavage for Intubated Trauma Patients With Tbi or Chest Trauma
Journal of Critical Care
2017

Characterization of Hypoalbuminemia Following Temporary Abdominal Closure
Journal of Trauma and Acute Care Surgery
2017

Antibiotics May Be Safely Discontinued Within One Week of Percutaneous Cholecystostomy
World Journal of Surgery
2017

Acute Kidney Injury Following Exploratory Laparotomy and Temporary Abdominal Closure
Shock
2017

The Long-Term Burden of Severe Sepsis and Septic Shock: Sepsis Recidivism and Organ Dysfunction
Journal of Trauma and Acute Care Surgery
2016

Sex-Based Differences in the Genomic Response, Innate Immunity, Organ Dysfunction, and Clinical Outcomes After Severe Blunt Traumatic Injury and Hemorrhagic Shock
Journal of Trauma and Acute Care Surgery
2016

Patterns of Gene Expression Among Murine Models of Hemorrhagic Shock/Trauma and Sepsis
Physiological Genomics
2016

Nutritional Support in the Setting of Persistent Inflammation, Immunosuppression, and Catabolism Syndrome (Pics)

2016

Multicenter external validation of the Geriatric Trauma Outcome Score: A Study by the Prognostic Assessment of Life and Limitations After Trauma in the Elderly [PALLIATE] Consortium
Journal of Trauma and Acute Care Surgery
2016

Intubated Trauma Patients Receiving Prolonged Antibiotics for Pneumonia Despite Negative Cultures: Predictors and Outcomes
Surgical Infections
2016

The Genomic Response After Burn Injury Predicts Organ Dysfunction and Mortality
Shock
2015

Human Myeloid Derived Suppressor Cells Induce Immune Suppression After Severe Sepsis
Shock
2015

Evaluation and Management of Blunt Traumatic Aortic Injury: a Practice Management Guideline From the Eastern Association for the Surgery of Trauma
Journal of Trauma and Acute Care Surgery
2015

Blunt Trauma Releases Cell Free Nucleic Acids, But Its Prognostic Relevance Does Not Surface Until the Following Day.
Shock
2015

Advanced Age Is Associated With Worsened Outcomes and a Unique Genomic Response in Severely Injured Patients With Hemorrhagic Shock
Critical Care
2015

A Protocol for the Management of Adhesive Small Bowel Obstruction
Journal of Trauma and Acute Care Surgery
2015

A Detailed Characterization of the Dysfunctional Immunity and Abnormal Myelopoiesis Induced By Severe Shock and Trauma in the Aged
Journal of Immunology
2015

Variability is the standard: the management of venous thromboembolic disease following trauma
Journal of Trauma and Acute Care Surgery
2014

The Lung Neutrophil Transcriptome After Trauma Influences the Worse Outcomes of the Old To Pneumonia
Critical Care Medicine
2014

The Female Transcriptomic Response After Severe Trauma Is Different From That of Males
Shock
2014

Inadequate Pmn Chemokine Receptor Expression After Polymicrobial Abdominal Sepsis Contributes To Defective Pmn Chemotaxis in the Aged
Shock
2014

Genomic Analysis of Individual Leukocyte Populations After Severe Trauma
Shock
2014

Advanced Age Is An Independent Predictor of Complicated Outcomes and Mortality Among Severely Injured Pateints in Hemorrhagic Shock
Shock
2014

A Comparison of the Leukocyte Genomic Responses To Sterile Or Infectious Inflammation
Shock
2014

Limb salvage after complex repairs of extremity arterial injuries is independent of surgical specialty training
Journal of Trauma and Acute Care Surgery
2013

Comparing clinical predictors of deep venous thrombosis versus pulmonary embolus after severe injury: A new paradigm for post-traumatic venous thromboembolism?
Journal of Trauma and Acute Care Surgery
2013

Changes in massive transfusion over time: An early shift in the right direction?

2012

A randomized, double-blind, placebo-controlled pilot trial of anticoagulation in low risk TBI: The Delayed vs. Early Enoxaparin Prophylaxis I study (DEEP I)
Journal of Trauma and Acute Care Surgery
2012

Predictors of early vs. late timing of pulmonary embolus after traumatic injury
American Journal of Surgery
2011

Outcomes and long term follow up after emergent cricothyroidotomy: Is routine conversion to tracheostomy necessary?
American Journal of Surgery
2011

Early blood product and crystalloid resuscitation: Risk association with multiple organ dysfunction after severe blunt traumatic injury

2011

Boerhaave syndrome presenting as massive hemothorax
Southern Medical Journal
2008

High-frequency percussive ventilation improves oxygenation in trauma patients with acute respiratory distress syndrome: a retrospective review
American Journal of Surgery
2006

DC-SIGN can modulate IL-2 production from PMA and anti-CD3 stimulated primary human CD4 T cells

2005

Detection of intra-abdominal injury using diagnostic peritoneal lavage following shotgun wound to the abdomen

2003

A prospective evaluation of the sensitivity of physical examination in chest trauma

2002

Research Interests

Dr. Brakenridge is member of a multidisciplinary research team investigating the persistent inflammation, immunosuppression and catabolism syndrome (PICS) that occurs after surgical sepsis or severe trauma. He is currently one of the principal investigators for an National Institutes of Health funded P50 center grant supporting the UF Sepsis and Critical Illness Research Center to study the persistent inflammation, immunosuppression and catabolism syndrome (PICS) following sepsis in surgical intensive care unit patients

His current research projects include:

Persistent inflammation/immunosuppresion and catabolism syndrome (PICS): Advances in critical care medicine over the past two decades have significantly decreased in-hospital mortality following sepsis in surgical and trauma patients. However, instead of dying from septic shock and sudden multiple organ failure, patients survive with an extended course of chronic critical illness. When we studied the epidemiology of these patients, we recognized that many of the survivors lingered in the intensive care unit with manageable organ dysfunctions. Their clinical course is characterized by recurrent inflammatory insults (e.g., repeat operations and nosocomial infections, which are those that originate in a hospital), a persistent acute-phase response with ongoing loss of lean body mass despite optimal nutritional support, poor wound healing and bedsores.

These patients (especially the elderly) are commonly discharged to long-term acute care facilities and skilled nursing facilities with significant cognitive and functional impairments, from which they rarely recover fully. Few ever return to independent function and more than 60 percent of these patients are dead within two years. The researchers in the laboratory of inflammation biology and surgical science at UF Health hypothesize that chronic critical illness, driven by PICS and characterized by morbid long-term outcomes, is now the predominant clinical trajectory in surgical ICU sepsis survivors.

Induced Frailty after Chronic Critical Illness: The Induced Frailty phenotype after sepsis or severe traumatic injury is similar to the frailty syndrome of elderly adults, which is a state of high vulnerability for adverse health outcomes. The overall concept of frailty during advanced age is a state of high vulnerability for adverse health outcomes, including disability, dependency, falls, need for long-term care and mortality. However, what is unique about the proposed phenotype of Induced Frailty is that it is an acute, rather than chronic change in health status, ultimately leading to poor long-term outcomes. Although not strictly age-dependent, this clinical phenotype appears to occur most commonly in older individuals that survive sepsis or severe traumatic injury, and develop a state of chronic critical illness (CCI) where functional, “robust” and “pre-frail” individuals before this insult subsequently develop a new, post-sepsis baseline state of cognitive, physiologic and functional morbidities consistent with the frailty syndrome of the elderly. As opposed to the slow, progressive, deterioration of the health state of elderly individuals described by traditional frailty, this frailty phenotype appears to develop within weeks to months of an acute, pro-inflammatory insult (such as sepsis or severe injury) yet persists and/or deteriorates over months to years, and often at a significantly younger age. We hypothesize that this clinical phenotype is secondary to well described mechanisms of persistent immunologic and catabolic dysfunction (i.e. PICS) that occur after sepsis.