PREcision Care In Cardiac ArrEst - ICECAP (PRECICECAP)

心脏骤停的精准护理 - ICECAP (PRECICECAP)

• 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
• 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

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.

项目摘要 心脏骤停中的PRECISE CARE- ICECAP（PRECICECAP）的目的是发现新的生物标志物 心脏骤停后脑和脑外器官衰竭的特征可预测治疗反应性 和长期恢复。我们将通过与ICECAP试验合作来实现这一目标， 寻找临床研究试验，旨在确定停搏后低温的最佳持续时间。心脏 逮捕是一个主要的公共卫生问题，发病率和死亡率都很高。五分之四的患者住院 心脏骤停后有明显的脑损伤，神经系统损伤死亡是常见的。改善 生存和功能恢复是一项重要的公共卫生目标，需要采取创新办法。 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、突发性危重病， 在如何最好地描述损伤严重程度和确定 个别患者可能受益于特定的神经保护策略。因此，发展高- 进行生物标记签名是一项关键需求，并将转化为护理的立即变化。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）， 通过我们创新的、多参数数据驱动的方法，我们将能够识别新的签名， 定义患者亚组。先进的数据科学和分析方法将有助于确定 这在以前是不可能的。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功能恢复的不同轨迹。这个项目 将在疾病过程的早期获得高分辨率的多模态数据，这将使我们能够解决这些问题。 目前的知识差距，并提高我们对疾病的早期急性环境的理解， 干预措施可以改善结果。这里学到的知识将应用于开发个性化的 心脏骤停幸存者的治疗，解决国家卫生研究院和我们的目标，延长寿命，减少 残疾。