Vasoactive Agents and Cerebral Outcomes in Brain Injury

血管活性药物和脑损伤中的脑结果

基本信息

  • 批准号:
    9029235
  • 负责人:
  • 金额:
    $ 24.99万
  • 依托单位:
  • 依托单位国家:
    美国
  • 项目类别:
  • 财政年份:
    2015
  • 资助国家:
    美国
  • 起止时间:
    2015-09-30 至 2017-08-31
  • 项目状态:
    已结题

项目摘要

 DESCRIPTION (provided by applicant): Trauma is the leading killer of children and adolescents, and traumatic brain injury (TBI) is the leading cause of pediatric trauma related death, where boys and young children have worse outcomes. When caring for injured children, front line physicians such as surgeons, anesthesiologists, emergency medicine physicians, and intensivists often struggle to prevent and/or expediently correct the unwanted but prevalent hypotension. This is problematic because systemic hypotension causes low cerebral perfusion (cerebral perfusion pressure [CPP] and cerebral blood flow [CBF], resulting in brain ischemia and poor outcomes. Moreover, cerebral autoregulation is impaired after TBI, which prevents brain perfusion during systemic hypotension. Current Level II recommendations are to maintain systolic blood pressure > 70 + 2 (age) and CPP above 40 mmHg. Intravenous vasoactive agents such as phenylephrine (PHE), norepinephrine (NE), dopamine (DA) and epinephrine (EPI), while used to treat hypotension after correction with fluids/ blood products, lack comparison with respect to desired effect. Thus, initial choice of vasoactive agent is largely empiric, and variable. Importantly, vasoactive agents have not been compared vis-à-vis their effect on cerebral outcomes (hemodynamics [CPP] and perfusion [CBF and cerebral autoregulation]) after trauma; virtually nothing is known about their mechanisms or how these mechanisms relate to TBI. Our previous work suggests that knowing which intravenous vasoactive better corrects hypotension is clinically important, vasoactive agents differentially affect the neurovascular unit (NVU), and that the NVU plays an important role in cerebral perfusion and outcomes. Yet, no mechanisms for cerebral perfusion or dysautoregulation have been elucidated in pediatric trauma/TBI. The overarching hypothesis is that commonly used intravenous vasoactive agents have differential mechanistic effects on cerebral outcomes in TBI, and these differences are related to sex and age. The Specific Aims are to: 1) Examine the association between intravenously administered vasoactive agents (PHE, NE, DA, EPI) and cerebral perfusion (hemodynamics and autoregulation) after TBI by age and sex, and 2) Investigate the mechanism by which vasoactive agents (PHE, NE, DA, EPI) affect cerebral hemodynamics and autoregulation after TBI in children by age and sex. The impact of this exploratory R21 study will be to provide new information as to whether and how initial choice of vasoactive agent affects the NVU, cerebral hemodynamics and cerebral perfusion characteristics in pediatric TBI by age and sex.


项目成果

期刊论文数量(0)
专著数量(0)
科研奖励数量(0)
会议论文数量(0)
专利数量(0)

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Monica S Vavilala其他文献

Racial and Ethnic Differences in Time to Completion of Academic Enrichment Program Applications
完成学术强化计划申请的时间上的种族和民族差异
  • DOI:
    10.7759/cureus.60054
  • 发表时间:
    2024
  • 期刊:
  • 影响因子:
    0
  • 作者:
    Kristian V Jones;A. Chitwanga;Qian Qiu;Aspen D Avery;Darya Yemets;Carolyn Theard;Chelsea Hicks;keith Hullenaar;Monica S Vavilala;Marie A Theard
  • 通讯作者:
    Marie A Theard
Identifying Common Data Elements to Achieve Injury-related Health Equity Across the Lifespan: A Consensus-Driven Approach
确定通用数据元素以实现整个生命周期中与伤害相关的健康公平:共识驱动的方法
  • DOI:
    10.1089/heq.2023.0044
  • 发表时间:
    2024
  • 期刊:
  • 影响因子:
    2.7
  • 作者:
    K. Conrick;Brianna Mills;Molly Fuentes;J. Graves;Christopher St Vil;Monica S Vavilala;Eileen M Bulger;Saman Arbabi;Ali Rowhani;Megan Moore
  • 通讯作者:
    Megan Moore
Computer Simulation to Assess Emergency Department Length of Stay in Pediatric Traumatic Brain Injury.
计算机模拟评估小儿脑外伤急诊科住院时间。
  • DOI:
  • 发表时间:
    2024
  • 期刊:
  • 影响因子:
    1.4
  • 作者:
    Tianshu Feng;Ali Ajdari;Linda Ng Boyle;N. Kannan;Randall Burd;Jonathan I Groner;R. A. Farneth;Monica S Vavilala
  • 通讯作者:
    Monica S Vavilala
Insights from Developing and Implementing a Novel School Community Collaborative Model to Promote School Safety.
开发和实施新型学校社区协作模式以促进学校安全的见解。
  • DOI:
    10.1111/josh.13451
  • 发表时间:
    2024
  • 期刊:
  • 影响因子:
    2.2
  • 作者:
    Keith L. Hullenaar;Chelsea D Hicks;Marcus W Stubblefield;Lester Herndon Flip;Susan K Seabrooks;Monica S Vavilala;Sharon S Laing
  • 通讯作者:
    Sharon S Laing

Monica S Vavilala的其他文献

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{{ truncateString('Monica S Vavilala', 18)}}的其他基金

Pediatric Injury Prevention Student Internship Training (INSIGHT)
儿科伤害预防学生实习培训(INSIGHT)
  • 批准号:
    10382766
  • 财政年份:
    2021
  • 资助金额:
    $ 24.99万
  • 项目类别:
CE19-001, Injury Health-related Equity across the Lifespan (iHeal)
CE19-001,整​​个生命周期中与伤害健康相关的公平性 (iHeal)
  • 批准号:
    10220784
  • 财政年份:
    2019
  • 资助金额:
    $ 24.99万
  • 项目类别:
CE19-001, Injury Health-related Equity across the Lifespan (iHeal)
CE19-001,整​​个生命周期中与伤害健康相关的公平性 (iHeal)
  • 批准号:
    10054917
  • 财政年份:
    2019
  • 资助金额:
    $ 24.99万
  • 项目类别:
CE19-001, Injury Health-related Equity across the Lifespan (iHeal)
CE19-001,整​​个生命周期中与伤害健康相关的公平性 (iHeal)
  • 批准号:
    10451467
  • 财政年份:
    2019
  • 资助金额:
    $ 24.99万
  • 项目类别:
CE19-001, Injury Health-related Equity across the Lifespan (iHeal)
CE19-001,整​​个生命周期中与伤害健康相关的公平性 (iHeal)
  • 批准号:
    10640214
  • 财政年份:
    2019
  • 资助金额:
    $ 24.99万
  • 项目类别:
Pediatric Injury Prevention Student Internship Training (INSIGHT)
儿科伤害预防学生实习培训(INSIGHT)
  • 批准号:
    10200104
  • 财政年份:
    2018
  • 资助金额:
    $ 24.99万
  • 项目类别:
Pediatric Injury Prevention Student Internship Training (INSIGHT)
儿科伤害预防学生实习培训(INSIGHT)
  • 批准号:
    10427207
  • 财政年份:
    2018
  • 资助金额:
    $ 24.99万
  • 项目类别:
Pediatric Injury Prevention Student Internship Training (INSIGHT)
儿科伤害预防学生实习培训(INSIGHT)
  • 批准号:
    9766885
  • 财政年份:
    2018
  • 资助金额:
    $ 24.99万
  • 项目类别:
Vasoactive Agents and Cerebral Outcomes in Brain Injury
血管活性药物和脑损伤中的脑结果
  • 批准号:
    9148197
  • 财政年份:
    2015
  • 资助金额:
    $ 24.99万
  • 项目类别:
Improving Indo-US Traumatic Brain Injury Outcomes
改善印美创伤性脑损伤的结果
  • 批准号:
    8337852
  • 财政年份:
    2011
  • 资助金额:
    $ 24.99万
  • 项目类别:

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州大麻政策会影响青少年大麻和酒精的使用吗?
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