Skip to main content

Advertisement

Log in

Research Priorities in Neurocritical Care

  • Review
  • Published:
Neurocritical Care Aims and scope Submit manuscript

Abstract

This summary of the last session of the First Neurocritical Care Research Conference reviews the discussions about research priorities in neurocritical care. The first presentation reviewed current projects funded by the National Institute of Neurological Disorders and Stroke at the National Institutes of Health and potential models to follow including an independent Neurocritical Care Network or the creation of such a network with the goal of collaborating with already existing ones. Experienced neurointensivists then presented their views on the most common and important research questions that need to be answered and investigated in the field. Finally, utility of clinical registries was discussed emphasizing their importance as hypothesis generators. During the group discussion, interests in comparative effectiveness research, the use of physiological endpoints from monitoring and alternate trial design were expressed.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Colohan AR, Alves WM, Gross CR, Torner JC, Mehta VS, Tandon PN, Jane JA. Head injury mortality in two centers with different emergency medical services and intensive care. J Neurosurg. 1989;71:202–7.

    Article  PubMed  CAS  Google Scholar 

  2. Gelpke GJ, Braakman R, Habbema JD, Hilden J. Comparison of outcome in two series of patients with severe head injuries. J Neurosurg. 1983;59:745–50.

    Article  PubMed  CAS  Google Scholar 

  3. Lingsma HF, Roozenbeek B, Li B, Marmarou A, Murray GD, Maas AI, Steyerberg EW. Large between-center differences in outcome after moderate and severe traumatic brain injury in the IMPACT study. Neurosurgery. 2011;68(3):601–7.

    Article  PubMed  Google Scholar 

  4. Maas AI, Harrison-Felix CL, Menon DK, Adelson D, Balkin T, Bullock R, Engel DC, Gordon W, Langlois J, Lew HL, Robertson C, Temkin N, Valadka A, Verfaellie M, Wainwright M, Wright DW, Schwab K. Common data elements for traumatic brain injury: recommendations from the Interagency Working Group on Demographics and Clinical Assessment. Arch Phys Med Rehabil. 2010;91:1641–9.

    Article  PubMed  Google Scholar 

  5. Vadeboncoeur TF, Davis DP, Ochs M, et al. The ability of paramedics to predict aspiration in patients undergoing prehospital rapid sequence intubation. J Emerg Med. 2006;30:131–6.

    Article  PubMed  Google Scholar 

  6. Acquarolo A, Urli T, Perone G, et al. Antibiotic prophylaxis of early onset pneumonia in critically ill comatose patients. A randomized study. Intensive Care Med. 2005;31:510–6.

    Article  PubMed  CAS  Google Scholar 

  7. Sirvent JM, Torres A, El-Ebiary M, et al. Protective effect of intravenously administered cefuroxime against nosocomial pneumonia in patients with structural coma. Am J Respir Crit Care Med. 1997;155:1729–34.

    PubMed  CAS  Google Scholar 

  8. Namen AM, Ely EW, Tatter SB, et al. Predictors of successful extubation in neurosurgical patients. Am J Respir Crit Care Med. 2001;163:658–64.

    PubMed  CAS  Google Scholar 

  9. Coplin WM, Pierson DJ, Cooley KD, et al. Implications of extubation delay in brain-injured patients meeting standard weaning criteria. Am J Respir Crit Care Med. 2000;161:1530–6.

    PubMed  CAS  Google Scholar 

  10. Hammond FM, Meighen MJ. Venous thromboembolism in the patient with acute traumatic brain injury: screening, diagnosis, prophylaxis, and treatment issues. J Head Trauma Rehabil. 1998;13:36–50.

    Article  PubMed  CAS  Google Scholar 

  11. Vergouwen MD, Roos YB, Kamphuisen PW. Venous thromboembolism prophylaxis and treatment in patients with acute stroke and traumatic brain injury. Curr Opin Crit Care. 2008;14:149–55.

    Article  PubMed  Google Scholar 

  12. Rogers FB, Shackford SR, Wilson J, et al. Prophylactic vena cava filter insertion in severely injured trauma patients: indications and preliminary results. J Trauma. 1993;35:637–41.

    Article  PubMed  CAS  Google Scholar 

  13. Spain DA, Richardson JD, Polk HC Jr, et al. Venous thromboembolism in the high-risk trauma patient: do risks justify aggressive screening and prophylaxis? J Trauma. 1997;42:463–7.

    Article  PubMed  CAS  Google Scholar 

  14. Timmons SD. The life-saving properties of blood: mitigating cerebral insult after traumatic brain injury. Neurocrit Care. 2006;5:1–3.

    Article  PubMed  Google Scholar 

  15. Carlson AP, Schermer CR, Lu SW. Retrospective evaluation of anemia and transfusion in traumatic brain injury. J Trauma. 2006;61:567–71.

    Article  PubMed  Google Scholar 

  16. Corwin HL, Gettinger A, Pearl RG, et al. The CRIT Study: anemia and blood transfusion in the critically ill–current clinical practice in the United States. Crit Care Med. 2004;32:39–52.

    Article  PubMed  Google Scholar 

  17. Hebert PC, Wells G, Blajchman MA, et al. A multicenter, randomized, controlled clinical trial of transfusion requirements in critical care. Transfusion Requirements in Critical Care Investigators, Canadian Critical Care Trials Group. N Engl J Med. 1999;340:409–17.

    Article  PubMed  CAS  Google Scholar 

  18. McIntyre LA, Fergusson DA, Hutchison JS, et al. Effect of a liberal versus restrictive transfusion strategy on mortality in patients with moderate to severe head injury. Neurocrit Care. 2006;5:4–9.

    Article  PubMed  Google Scholar 

  19. Grande PO. The “Lund Concept” for the treatment of severe head trauma-physiological principles and clinical application. Intensive Care Med. 2006;32:1475–84.

    Article  PubMed  Google Scholar 

  20. Myburgh J, Cooper DJ, Finfer S, et al. Saline or albumin for fluid resuscitation in patients with traumatic brain injury. N Engl J Med. 2007;357:874–84.

    Article  PubMed  CAS  Google Scholar 

  21. Agency for Healthcare Research and Quality (AHRQ) and their 2007 handbook.

  22. Hammill B, Hernandez A, Peterson E, Fonarow G, Schulman K, Curtis L. Linking inpatient clinical registry data to Medicare claims data using indirect identifiers. Am Heart J. 2009;157:995–1000.

    Article  PubMed  Google Scholar 

  23. Guyatt GH, Oxman AD, Vist G, et al. The GRADE Working Group: “Rating Quality of Evidence and Strength of Recommendations GRADE: an emerging consensus on rating quality of evidence and strength of recommendations”. Br Med J. 2008;336:924–6.

    Article  Google Scholar 

  24. Dreye NA. GRACE Initiative: Do we need good practice principles for observational comparative effectiveness research? GRACE Initiative. www.graceprinciples.org August 2008.

  25. Ospina-Tascon GA, Buchele GL, Vincent JL. Multicenter, randomized, controlled trials evaluating mortality in intensive care: doomed to fail?. Crit Care Med. 2008;36:1311–22.

    Article  PubMed  Google Scholar 

  26. Menon DK. Unique challenges in clinical trials in traumatic brain injury. Crit Care Med. 2009;37(Suppl 1):S129–35.

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

The First Neurocritical Care Research Conference was funded by award R13NS065494 from the National Institute of Neurological Disorders and Stroke (P.I.: JI Suarez), the Integra Foundation, and the Neuroscience Center of the St Luke’s Episcopal Hospital in Houston, TX, and endorsed by the Neurocritical Care Society.

Disclosures

The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institute of Neurological Disorders and Stroke of the National Institutes of Health.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to R. G. Geocadin.

Additional information

This study was conducted for the First Neurocritical Care Research Conference Investigators and the complete list of investigators is presented in Appendix.

Appendix

Appendix

The First Neurocritical Care Research Conference Investigators:

Organizing Committee

Chair: Suarez JI, MD, Baylor College of Medicine, Houston, TX; Calvillo E, RN, Baylor College of Medicine, Houston, TX; Geocadin R, MD, Johns Hopkins University, Baltimore, MD; Hall C, MD, UT Southwestern University; Le Roux PD, MD, University of Pennsylvania, Philadelphia, PA; Livesay S, MS, RN, ACNP, St Luke’s Episcopal Hospital, Houston, TX; Mayer SA, MD, Columbia University, New York, NY; Vespa P, MD, UCLA, Los Angeles, CA; Wijman C, MD, Stanford University, Palo Alto, CA; Zaidat OO, MD, MS, Medical College of Wisconsin, Milwaukee, WI.

Speakers

Bleck TP, Rush School of Medicine, Chicago, IL; Chang C, MD, University of Hawaii, John A. Burns School of Medicine, Honolulu, HI; Cooper DJ, MD, Alfred Hospital and Monash University, Melbourne, Australia; Guntupalli KK, MD, Baylor College of Medicine, Houston, TX; Daily J, PhD, Case Western Reserve University, Cleveland, OH; Diringer MA, MD, Washington University School of Medicine, St Louis, MO; Robertson CS, MD, Baylor College of Medicine, Houston, TX; Hanley DF, MD, Johns Hopkins University, Baltimore, MD; Hemphill C III, MD, PhD, University of California in San Francisco, San Francisco, CA; Koroshetz W, MD, Deputy Director, NINDS, Bethesda. MD; Mirski MA, MD, PhD, Johns Hopkins University, Baltimore, MD; Palesch Y, PhD, Medical University of South Carolina; Qureshi AI, MD, University of Minnesota, Minneapolis, MN; Silbergleit R, MD, University of Michigan, Ann Arbor, MI; Smirnakis SM, MD, PhD, Baylor College of Medicine, Houston, TX; Szigeti K, MD, PhD, Baylor College of Medicine, Houston, TX.

Attendees

Adeoye O, MD, University of Cincinnati College of Medicine, Cincinnati, OH; Aisiku IP, University of Texas in Houston, Houston, TX; Bader MK, RN, Mission Viejo Hospital, Mission Viejo, CA; Ansari S, MD, Baylor College of Medicine, Houston, TX; Arshad ST, MD, Baylor College of Medicine, Houston, TX; Badjatia N, MD, Columbia University, New York, NY; Barazangi N, MD, Ph.D., Califorrnia Pacific Medical Center, San Francisco, CA; Bershad EM, MD, Baylor College of Medicine, Houston, TX; Boyd C, RN, MBA, St Luke’s Episcopal Hospital, Houston, TX; Claassen J, MD, Columbia University, New York, NY; Coplin W, MD, Wayne State University, Detroit, MI; Corry JJ, Henry Ford Hospital, Detroit, MI; Cruz-Florez S, MD, St Louis University, St Louis, MO; Dhar R, MD, Washington University School of Medicine, St Louis, MO; Dillon C, MS, Medical University of South Carolina, Charleston, SC; Divani AA, Ph.D., University of Minnesota, Minneapolis, MN; Duckworth E, MD, Baylor College of Medicine, Houston, TX; Ezzedine M, MD, University of Minnesota, Minneapolis, MN; Feen E, MD, St Louis University, St Louis, MO; Freeman W, MD, Mayo Clinic Florida, Jacksonville, FL; Frontera J, MD, Mount Sinai School of Medicine, New York, NY; Goodman JC, MD, Baylor College of Medicine, Houston, TX; Graffagnino C, MD, Duke University, Durham, NC; Hoesch RE, MD, PhD, Johns Hopkins University, Baltimore, MD; Ko NU, MD, University of California in San Francisco, San Francisco, CA; Koening M, MD, Johns Hopkins University, Baltimore, MD; Kramer A, University of Calgary, Calgary, AL, Canada; Lazaridis C, MD, Medical University of South Carolina, Charleston, SC; Lee JC, MD, Baylor College of Medicine, Houston, TX; Ling G, MD, PhD, US Armed Forces, Bethesda, MD; Macdonald RL, MD, Ph.D., University of Toronto, Toronto, ON, Canada; Malkoff M, MD, University of New Mexico, Albuquerque, NM; Mandava P, MD, Baylor College of Medicine, Houston, TX; Manno E, MD, Mayo Clinic, Rochester, MN; Martin H Renee, Ph.D., Medical University of South Carolina, Charleston, SC; Mawad M, MD, Baylor College of Medicine, Houston, TX; Mizrahi E, MD, Baylor College of Medicine, Houston, TX; McArthur DL, Ph.D., UCLA, Los Angeles, CA; Nathan B, MD, University of Virginia, Charlottesville, VA; Newmark M, MD, Baylor College of Medicine, Houston, TX; Nguyen T, PharmD, St Luke’s Episcopal Hospital, Houston, TX; Nyquist P, MD, Ph.D., The Johns Hopkins Hospital, Baltimore, MD; Oliveira J, Hospital San Rafael, Universidade Federale da Bahia, Salvador, Brazil; Olson DW, RN, PhD, Duke University, Durham, NC; Ougorets I, MD, New York Weil Medical College of Cornell University, New York, NY; Puppo C, MD, Universidad de la República, Montevideo, Uruguay; Pyne-Geithman G, Ph.D., University of Cincinnati, Cincinnati, OH; Rao CPV, Baylor College of Medicine, Houston, TX; Revuelto J, MD, Hospital Virgen del Rocio, Seville, Spain Rhoney D, PharmD, Detroit Receiving Hospital, Detroit, MI; Riviello J, MD, Baylor College of Medicine, Houston, TX; Sawaya R, MD, Baylor College of Medicine, Houston, TX; Seder D, MD, Maine Medical Center, Portland, ME; Sheth K, MD, Brigham and Women’s Hospital, Boston, MA; Souter M, MD, University of Washington, Seattle, WA; Strutt AM, Ph.D., Baylor College of Medicine, Houston, TX; Suri MFK, MD, University of Minnesota, Minneapolis, MN; Temes R, MD, RUSH Medical Center, Chicago, IL; Torbey MT, MD, MPH, Medical College of Wisconsin, Milwaukee, WI; Treggiari M, University of Washington, Seattle, WA; Urfy MZ, MD, Baylor College of Medicine, Houston, TX Varelas P, MD, Ph.D., Henry Ford Hospital, Detroit, MI; Wright W, MD, Emory University, Atlanta, GA; York MK, Ph.D., Baylor College of Medicine, Houston, TX; Ziai W, MD, Johns Hopkins University, Baltimore, MD; Zwillman M, MD, The Methodist Hospital, Houston, TX.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Geocadin, R.G., Bleck, T.P., Koroshetz, W.J. et al. Research Priorities in Neurocritical Care. Neurocrit Care 16, 35–41 (2012). https://doi.org/10.1007/s12028-011-9611-y

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12028-011-9611-y

Keywords

Navigation