Quantitative electroencephalography after cardiac arrest

心脏骤停后定量脑电图

基本信息

批准号：
10197229
负责人：
Jonathan Elmer
金额：
$ 18.98万
依托单位：
UNIVERSITY OF PITTSBURGH AT PITTSBURGH
依托单位国家：
美国
项目类别：
财政年份：
2017
资助国家：
美国
起止时间：
2017-04-01 至 2022-03-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10197229
关键词：
Address Adult Algorithms American Anoxia Award Bayesian Modeling Biological Markers Brain Brain Hypoxia Brain Injuries Brain hemorrhage Cardiopulmonary Resuscitation Caring Cause of Death Cerebral Hypoxia Cessation of life Characteristics Clinical Clinical Data Complex Critical Illness Data Dedications Derivation procedure Detection Deterioration Development Disabled Persons Electroencephalography Elements Environment Evoked Potentials Family Functional disorder Goals Gold Heart Arrest Hospitals Hour Hypoxia Image Individual Injury Intervention Ischemic Stroke K-Series Research Career Programs Laboratories Link Measures Mentors Mentorship Methods Modeling Monitor Morbidity - disease rate Neurologic Neurological outcome Neurosciences Research Outcome Oxygen Patient Care Patient Selection Patient-Focused Outcomes Patients Perfusion Perinatal Pharmaceutical Preparations Physiologic pulse Physiological Process Productivity Prognosis Protocols documentation Public Health Reaction Time Reference Standards Research Research Personnel Research Training Resolution Resources Resuscitation Sampling Series Services Severities Signal Transduction Statistical Methods Subarachnoid Hemorrhage Survivors Syndrome Temperature Testing Time Tissues Titrations Training Treatment Protocols Validation Vasospasm Withdrawal Work base brain electrical activity brain tissue career cerebral hypoperfusion clinical care cohort cost design disability experience high risk hypoperfusion improved improved outcome innovation life-sustaining therapy mortality multimodality neurophysiology novel outcome prediction participant enrollment personalized care premature pressure prevent prognostic prognostic value prospective relational database response severe injury time use tool treatment strategy

项目摘要

Title: Quantitative electroencephalography after cardiac arrest Abstract Brain injury is the most dreaded result of critical illness. For more than half a million Americans who suffer sudden cardiac arrest each year, current therapies are inadequate and outcomes are abysmal. Among more than 100,000 patients who regain pulses, severe global brain injury is common and the major driver of both morbidity and mortality. This is a major public health problem. My proposal addresses two important, potentially preventable causes of death and disability due to post-arrest brain injury. The first of these problems is secondary brain injury from ongoing tissue hypoxia and hypoperfusion in the days after resuscitation. Outcomes are further worsened by inaccurate neurological prognostication, which directly increases mortality through premature withdrawal of care in patients who might otherwise have had favorable recoveries. Quantitative electroencephalography (qEEG) is a tool that measures individual components or overall characteristics of electrical brain activity, and may help overcome both of these problems. In our first aim, we will use innovative statistical methods to determine whether qEEG can noninvasively detect brain tissue hypoxia and hypoperfusion. We already use invasive monitoring to measure brain oxygen and perfusion, providing an unprecedented opportunity to test contemporaneously acquired qEEG against accepted clinical reference standards. Identification of qEEG markers of secondary brain injury would allow early and non-invasive patient care based on individualized need and real-time response to therapy. In the second aim, we will define the ability of qEEG signatures to predict subsequent neurological deterioration and death, and test its value as one element of a multistep prognostic algorithm. Currently, accurate prognostication is optimal only days after arrest. This is burdensome for families, resource intensive and often leads to premature withdrawal of life-sustaining therapy in patients who would otherwise have awakened and been able to live independently had they been given more time to recover. This career development award will directly contribute to my long-term research goals to develop, test, and implement innovative treatment strategies that reduce the burden of preventable brain injury in the critically ill. The award will provide me with the cross-disciplinary mentored experience and training necessary to achieve these goals and become a productive independent investigator.

标题：心脏骤停后的定量脑电图抽象的脑损伤是危重疾病最可怕的结果。对于超过 50 万遭受苦难的美国人每年都会发生心脏骤停，目前的治疗方法不足，结果很糟糕。其中还有更多超过 100,000 名患者恢复了脉搏，严重的全球性脑损伤很常见，并且是两者的主要驱动因素发病率和死亡率。这是一个重大的公共卫生问题。我的提案涉及两个重要的、可能可预防的逮捕后死亡和残疾原因脑损伤。第一个问题是持续组织缺氧造成的继发性脑损伤复苏后几天内灌注不足。不准确的神经学检查结果会进一步恶化预测，这会因患者过早退出护理而直接增加死亡率否则可能会有良好的恢复。定量脑电图（qEEG）是一种工具测量脑电活动的各个组成部分或整体特征，并可能有助于克服这两个问题。在我们的第一个目标中，我们将使用创新的统计方法来确定是否 qEEG可以无创地检测脑组织缺氧和低灌注。我们已经使用侵入式监测测量脑氧和灌注，提供前所未有的同时测试机会根据公认的临床参考标准获得 qEEG。二次 qEEG 标记的鉴定脑损伤将允许基于个性化需求和实时的早期和非侵入性患者护理对治疗的反应。在第二个目标中，我们将定义 qEEG 签名预测后续的能力神经功能恶化和死亡，并测试其作为多步骤预后算法要素之一的价值。目前，准确的预测在逮捕后几天才是最佳的。这对家庭、资源来说都是负担强化治疗，通常会导致患者过早停止维持生命的治疗如果他们有更多的时间康复的话，他们已经觉醒并能够独立生活。该职业发展奖将直接有助于我的长期研究目标，即开发、测试和实施创新的治疗策略，减轻危重病人可预防的脑损伤的负担。这该奖项将为我提供实现这些目标所需的跨学科指导经验和培训并成为一名富有成效的独立调查员。

项目成果

期刊论文数量（62）

专著数量（0）

科研奖励数量（0）

会议论文数量（0）

专利数量（0）

Variability of Post-Cardiac Arrest Care Practices Among Cardiac Arrest Centers: United States and South Korean Dual Network Survey of Emergency Physician Research Principal Investigators.

心脏骤停中心心脏骤停后护理实践的差异：美国和韩国急诊医师研究主要研究者的双网络调查。

DOI：
发表时间：
2017-03
期刊：
影响因子：
0
作者：
Coppler, Patrick J;Sawyer, Kelly N;Youn, Chun Song;Choi, Seung Pill;Park, Kyu Nam;Kim, Young;Reynolds, Joshua C;Gaieski, David F;Lee, Byung Kook;Oh, Joo Suk;Kim, Won Young;Moon, Hyung Jun;Abella, Benjamin S;Elmer, Jonathan;Callaway, Clif
通讯作者：
Callaway, Clif

A nuanced view of post-anoxic myoclonus.

缺氧后肌阵挛的细致观察。

DOI：
发表时间：
2017-06
期刊：
影响因子：
6.5
作者：
Elmer, Jonathan;Sandroni, Claudio
通讯作者：
Sandroni, Claudio

Effect of sedation on quantitative electroencephalography after cardiac arrest.

镇静对心脏骤停后定量脑电图的影响。

DOI：
发表时间：
2018-03
期刊：
影响因子：
6.5
作者：
Drohan, Callie M;Cardi, Alessandra I;Rittenberger, Jon C;Popescu, Alexandra;Callaway, Clifton W;Baldwin, Maria E;Elmer, Jonathan
通讯作者：
Elmer, Jonathan

An Algorithm for Automated, Noninvasive Detection of Cortical Spreading Depolarizations Based on EEG Simulations.

一种基于脑电图模拟的自动、无创检测皮质扩散去极化的算法。

DOI：
发表时间：
2019-04
期刊：
影响因子：
0
作者：
Chamanzar, Alireza;George, Shilpa;Venkatesh, Praveen;Chamanzar, Maysamreza;Shutter, Lori;Elmer, Jonathan;Grover, Pulkit
通讯作者：
Grover, Pulkit

Optimizing cerebral oxygen delivery after cardiac arrest: A role for neuromonitoring.

心脏骤停后优化脑氧输送：神经监测的作用。