PREcision Care In Cardiac ArrEst - ICECAP (PRECICECAP)

NIH Pandemic-Era Grants

Pandemic Era Grants

2024

↗ Live URL (may be dead)

Document text

Principal Investigator: Jonathan  Elmer
Organization: STANFORD UNIVERSITY
Fiscal Year: 2024
Award: $1,155,493
Funding agency: National Institute of Neurological Disorders and Stroke

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.

Terms: <Acquired brain injury><Acute><Acute Disease><Address><Affect><Asystole><Benchmarking><Best Practice Analysis><Biological Markers><Brain><Brain Dead><Brain Death><Brain Injuries><Brain Nervous System><Cardiac Arrest><Cardiopulmonary><Cardiopulmonary Physiology><Caring><Cephalic><Cerebrum><Cessation of life><Clinical><Clinical Research><Clinical Study><Coma Depasse><Cranial><Critical Care><Critical Illness><Critically Ill><Data><Data Analytics><Data Science><Data Set><Death><Development><Diagnostic><Disease><Disorder><Dose><Dysfunction><EEG><Electroencephalogram><Electroencephalography><Electrophysiology><Electrophysiology (science)><Encephalon><Foundations><Functional disorder><Goals><Head><Heart Arrest><Heterogeneity><Hospital Admission><Hospitalization><Hypothermia><Hypoxic-Ischemic Brain Injury><Image><Individual><Injury><Intervention><Intervention Strategies><Investigators><Knowledge><Lead><Learning><Life><Measurable><Measures><Methods><Modality><Molecular><Monitor><Morbidity><Morbidity - disease rate><NIH><National Institutes of Health><Nervous System Injuries><Nervous System Trauma><Nervous System damage><Neurologic><Neurologic Examination><Neurological><Neurological Damage><Neurological Examination><Neurological Injury><Neurological trauma><Neurophysiology / Electrophysiology><Neurosciences><Organ><Organ failure><Outcome><Patient outcome><Patient-Centered Outcomes><Patient-Focused Outcomes><Patients><Pattern><Pb element><Performance><Physiologic><Physiological><Physiology><Physiopathology><Position><Positioning Attribute><Precision care><Prediction of Response to Therapy><Public Health><Pupil light reflex><Radiography><Random Allocation><Random Selection><Recovery><Recovery of Function><Research><Research Personnel><Researchers><Resolution><Rewarming><Roentgenography><Role><Sampling><Severities><Severity of illness><Source><Specificity><Standardization><Subgroup><Survivors><Temperature><Testing><Time><Titrations><Translating><United States National Institutes of Health><Validation><Work><acute disease/disorder><acute disorder><advanced analytics><arm><benchmark><bio-markers><biologic marker><biomarker><biomarker signature><brain damage><brain-injured><candidate biomarker><candidate marker><cerebral><cerebral death><clinical care><clinical predictors><computer based prediction><design><designing><developmental><disability><disease severity><electrophysiological><functional recovery><heavy metal Pb><heavy metal lead><imaging><improved><improved outcome><individual patient><individualized care><individualized patient care><injuries><innovate><innovation><innovative><intervention arm><interventional strategy><long term recovery><mortality><multi-modal data><multi-modal datasets><multi-modality><multidisciplinary><multimodal data><multimodal datasets><multimodality><natural hypothermia><neuroprotection><neuroprotective><neurotrauma><new marker><novel><novel biomarker><novel marker><outcome prediction><pathophysiology><patient oriented outcomes><patient subclass><patient subcluster><patient subgroups><patient subpopulations><patient subsets><patient subtypes><personalization of treatment><personalized care><personalized medicine><personalized patient care><personalized therapy><personalized treatment><precision medicine><precision-based medicine><predict therapeutic response><predict therapy response><predictive biomarkers><predictive marker><predictive modeling><predictive molecular biomarker><prognostic><prognostic ability><prognostic power><prognostic utility><prognostic value><prospective><pupillary light reflex><pupillary reflex><radiologic imaging><radiological imaging><random forest><resolutions><response><response to therapy><response to treatment><social role><supervised learning><supervised machine learning><therapeutic response><therapy prediction><therapy response><tool><treatment arm><treatment effect><treatment prediction><treatment response><treatment response prediction><treatment responsiveness><unsupervised learning><unsupervised machine learning><validations>