PREcision Care In Cardiac ArrEst - ICECAP (PRECICECAP)

心脏骤停的精准护理 - ICECAP (PRECICECAP)

基本信息

批准号：
10526409
负责人：
Jonathan Elmer
金额：
$ 123.75万
依托单位：
STANFORD UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2020
资助国家：
美国
起止时间：
2020-12-15 至 2026-04-30
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10526409
关键词：
Acute Acute Disease Address Affect Benchmarking Biological Markers Brain Brain Death Brain Injuries Cardiopulmonary Cardiopulmonary Physiology Caring Cephalic Cerebrum Cessation of life Clinical Clinical Research Critical Care Critical Illness Data Data Analytics Data Science Data Set Development Diagnostic Disease Dose Electroencephalography Electrophysiology (science)Foundations Functional disorder Goals Head Heart Arrest Heterogeneity Hospitalization Hypoxic-Ischemic Brain Injury Image Individual Injury Intervention Knowledge Lead Learning Life Measurable Measures Methods Modality Molecular Monitor Morbidity - disease rate Nervous System Trauma Neurologic Neurologic Examination Neurosciences Organ Organ failure Outcome Patient-Focused Outcomes Patients Pattern Performance Physiological Physiology Positioning Attribute Prediction of Response to Therapy Public Health Pupil light reflex Random Allocation Recovery Recovery of Function Research Research Personnel Resolution Rewarming Role Sampling Severities Severity of illness Source Specificity Standardization Subgroup Survivors Temperature Testing Time Titrations Translating United States National Institutes of Health Validation Work advanced analytics arm biomarker signature candidate marker clinical care clinical predictors design disability improved improved outcome individual patient innovation long term recovery mortality multidisciplinary multimodal data multimodality natural hypothermia neuroprotection novel novel marker outcome prediction patient subsets personalized care personalized medicine precision medicine predictive marker predictive modeling prognostic prognostic value prospective radiological imaging random forest response supervised learning tool treatment arm treatment effect treatment response unsupervised learning

项目摘要

Project Summary The objective of PREcision Care In Cardiac ArrEst - ICECAP (PRECICECAP) is to discover novel biomarker signatures of post cardiac arrest brain and extracerebral organ failure that predict treatment responsiveness and long-term recovery. We will achieve this by partnering with the ICECAP trial, a response-adaptive dose finding clinical research trial that seeks to determine the optimal duration of post-arrest hypothermia. Cardiac arrest is a major public health problem with high morbidity and mortality. Four in five patients hospitalized after cardiac arrest have significant brain injury, and death from neurologic damage is common. Improving survival and functional recovery is a critical public health objective and will require innovative approaches. The current clinical situation is unprecedented. Currently post-CA brain injury is an acute, sudden critical illness with major knowledge gaps about how best to characterize severity of injury and to identify which individual patients are likely to benefit from specific neuroprotective strategies. Thus, development of high- performing biomarker signatures is a critical need and would translate in to immediate changes in care. We hypothesize that not all patients are identical (i.e. there will be a heterogeneity of treatment effect) and that through our innovative, multi-parametric data driven approach, we will be able to identify novel signatures that define subgroups of patients. Advanced data science and analytical approaches will allow the identification of these subgroups that was previously not possible. These subgroups will be clinically important insofar as they will indicate differential responses to treatment and different trajectories of functional recovery. This project will acquire high resolution multi-modal data early in the disease course that will allow us to address these current knowledge gaps and improve our understanding of the disease in the early acute setting when interventions can improve outcome. The knowledge learned here will be applied to develop personalized treatments for cardiac arrest survivors, addressing the NIH's and our goals of lengthening life and reducing disability.

项目概要心脏骤停精准护理 - ICECAP (PRECICECAP) 的目标是发现新的生物标志物心脏骤停后大脑和脑外器官衰竭的特征可预测治疗反应和长期康复。我们将通过与 ICECAP 试验合作来实现这一目标，这是一种反应适应性剂量寻找旨在确定逮捕后低温的最佳持续时间的临床研究试验。心脏逮捕是一个重大的公共卫生问题，发病率和死亡率很高。五分之四的患者住院心脏骤停后出现严重的脑损伤，因神经系统损伤而死亡的情况很常见。改善生存和功能恢复是一个重要的公共卫生目标，需要创新的方法。目前的临床情况是前所未有的。目前，CA 后脑损伤是一种急性、突发性危重症疾病在如何最好地描述伤害严重程度并确定哪些伤害方面存在重大知识差距个别患者可能受益于特定的神经保护策略。因此，发展高执行生物标志物签名是一项关键需求，并将转化为护理方面的立即变化。我们假设并非所有患者都是相同的（即治疗效果存在异质性）并且通过我们创新的多参数数据驱动方法，我们将能够识别新颖的签名定义患者亚组。先进的数据科学和分析方法将能够识别这些子组以前是不可能的。这些亚组在临床上很重要，因为它们将表明对治疗的不同反应和不同的功能恢复轨迹。这个项目将在病程早期获取高分辨率多模式数据，这将使我们能够解决这些问题当前的知识差距，并提高我们在早期急性环境中对该疾病的了解干预措施可以改善结果。在这里学到的知识将应用于开发个性化的对心脏骤停幸存者的治疗，实现 NIH 和我们延长生命和减少生命的目标残疾。