Justin Belsky, MD, MPH
Assistant Professor of Emergency MedicineCards
About
Research
Overview
Medical Research Interests
Bacteremia; Biomarkers; COVID-19; Pneumonia, Bacterial; Respiratory Tract Infections; Sepsis; Shock, Septic; Urinary Tract Infections
Public Health Interests
Influenza
Publications
Featured Publications
Early Restrictive or Liberal Fluid Management for Sepsis-Induced Hypotension.
National Heart, Lung, and Blood Institute Prevention and Early Treatment of Acute Lung Injury Clinical Trials Network, Shapiro NI, Douglas IS, Brower RG, Brown SM, Exline MC, Ginde AA, Gong MN, Grissom CK, Hayden D, Hough CL, Huang W, Iwashyna TJ, Jones AE, Khan A, Lai P, Liu KD, Miller CD, Oldmixon K, Park PK, Rice TW, Ringwood N, Semler MW, Steingrub JS, Talmor D, Thompson BT, Yealy DM, Self WH. Early Restrictive or Liberal Fluid Management for Sepsis-Induced Hypotension. N Engl J Med 2023, 388: 499-510. PMID: 36688507, DOI: 10.1056/NEJMoa2212663.Peer-Reviewed Original ResearchAssociation of Vitamin C, Thiamine, and Hydrocortisone Infusion With Long-term Cognitive, Psychological, and Functional Outcomes in Sepsis Survivors: A Secondary Analysis of the Vitamin C, Thiamine, and Steroids in Sepsis Randomized Clinical Trial.
Williams Roberson S, Nwosu S, Collar EM, Kiehl A, Harrison FE, Bastarache J, Wilson JE, Mart MF, Sevransky JE, Ely EW, Lindsell CJ, Jackson JC, VICTAS Investigators. Association of Vitamin C, Thiamine, and Hydrocortisone Infusion With Long-term Cognitive, Psychological, and Functional Outcomes in Sepsis Survivors: A Secondary Analysis of the Vitamin C, Thiamine, and Steroids in Sepsis Randomized Clinical Trial. JAMA Netw Open 2023, 6: e230380. PMID: 36853612, DOI: 10.1001/jamanetworkopen.2023.0380.Peer-Reviewed Original ResearchEstablishment of SEP-1 national practice guidelines does not impact fluid administration for septic shock patients
Boccio E, Haimovich A, Jacob V, Zhao X, Wira CR, Venkatesh A, Belsky J. Establishment of SEP-1 national practice guidelines does not impact fluid administration for septic shock patients. The American Journal Of Emergency Medicine 2022, 62: 19-24. PMID: 36209655, DOI: 10.1016/j.ajem.2022.09.038.Peer-Reviewed Original ResearchConceptsSeptic shock patientsShock patientsFluid administrationFluid managementSevere sepsis/septic shockSepsis/septic shockEarly Management BundleRetrospective observational analysisDate of presentationNational practice guidelinesUrban academic centerNational quality measuresLogistic regression analysisOdds of complianceHigh-quality careSepsis severityPrimary outcomeSeptic shockED settingResuscitation strategiesBlood culturesPractice patternsOdds ratioPractice guidelinesProvider practicesSepsis Fluid Metric Compliance and its Impact on Outcomes of Patients with Congestive Heart Failure, End-Stage Renal Disease or Obesity
Boccio E, Haimovich A, Jacob V, Maciejewski KR, Wira CR, Belsky J. Sepsis Fluid Metric Compliance and its Impact on Outcomes of Patients with Congestive Heart Failure, End-Stage Renal Disease or Obesity. Journal Of Emergency Medicine 2021, 61: 466-480. PMID: 34088547, DOI: 10.1016/j.jemermed.2021.03.004.Peer-Reviewed Original ResearchConceptsEnd-stage renal diseaseCongestive heart failurePre-existing congestive heart failurePre-existing conditionsMultiple pre-existing conditionsShock patientsHeart failureRenal diseaseEmergency departmentED patient encountersOutcomes of patientsRetrospective chart reviewSeptic shock patientsFluid overload statesLength of stayUrban academic centerFluid goalChart reviewSeptic shockFluid administrationFluid bolusEmergency physiciansObesityPatientsAcademic centersEffect of Vitamin C, Thiamine, and Hydrocortisone on Ventilator- and Vasopressor-Free Days in Patients With Sepsis
Sevransky J, Rothman R, Hager D, Bernard G, Brown S, Buchman T, Busse L, Coopersmith C, DeWilde C, Ely E, Eyzaguirre L, Fowler A, Gaieski D, Gong M, Hall A, Hinson J, Hooper M, Kelen G, Khan A, Levine M, Lewis R, Lindsell C, Marlin J, McGlothlin A, Moore B, Nugent K, Nwosu S, Polito C, Rice T, Ricketts E, Rudolph C, Sanfilippo F, Viele K, Martin G, Wright D, Nugent K, Spainhour C, Polito C, Moore B, Negrin L, Khan A, Kea B, Krol O, Haq E, Pinkert V, Nguyen K, Brown S, Bledsoe J, Peltan I, Applegate D, Armbruster B, Montgomery Q, Brown K, Daw A, Gong M, Aboodi M, Chen J, Hope A, Gummadi S, Lopez B, Hinson J, Hager D, Ricketts E, Clements C, Gajic O, Kashyap R, Vanmeter D, Busse L, McBride M, Ginde A, Moss M, Finck L, Howell M, McKeehan J, Higgins C, Clare J, McBryde B, Barksdale A, Kalin D, Kruse D, Hilz K, Qadir N, Chang S, Beutler R, Tam A, Harris E, Youngquist S, Middleton E, Davidov E, Plante A, Belsky J, Siner J, Wira C, Brokowski C, Steingrub J, Smithline H, Thornton-Thompson S, Fowler A, Miller S, Narron K, Puskarich M, Prekker M, Hendrickson A, Quinn J, Wilson J, Levitt J, Mann R, Visweswaran A, Gentile N, Marchetti N, Reimer H, Guirgis F, Jones L, Black L, Henson M, Meyer N, Greenwood J, Ittner C, Rivers E, Jayaprakash N, Gardner-Gray J, Hurst G, Pflaum J, Jaehne A, Gill J, Cook A, Janz D, Vonderhaar D, Romaine C, Wilkerson R, McCurdy M, Beach D, Lasko K, Gill R, Price K, Dickson L, Duggal A, Mace S, Hite R, Hastings A, Haukoos J, Douglas I, Trent S, Lyle C, Cupelo A, Gravitz S, Hiller T, Oakes J, LoVecchio F, Quiroga P, Danley S, Mulrow M, Encinas A, Goodwin A, Hall G, Grady A, Exline M, Terndrup T, Pannu S, Robart E, Karow S, Files D, Smith L, Gibbs K, Flores L, Pastores S, Shaz D, Kostelecky N, Case C, Wilkins E, Gaieski D, Baram M, Schwegler D, Renzi N, Mosier J, Hypes C, Campbell E, Hooper M, Sill J, Mitchell K, Hudock K, Lyons M, Gorder K, Ahmad Y, Studer A, Davis J, Barrett M, Nomura J, Knox J, Park P, Co I, McSparron J, Hyzy R, McDonough K, Hanna S, Self W, Semler M, Hays M, Bartz R, Limkakeng A, Sweeney K, Woodburn R, Goyal M, Zaaqoq A, Moriarty T, Oropello J, Zhang Z. Effect of Vitamin C, Thiamine, and Hydrocortisone on Ventilator- and Vasopressor-Free Days in Patients With Sepsis. JAMA 2021, 325: 742-750. PMID: 33620405, PMCID: PMC7903252, DOI: 10.1001/jama.2020.24505.Peer-Reviewed Original ResearchMeSH KeywordsAdultAgedAnti-Inflammatory AgentsAscorbic AcidCritical IllnessDouble-Blind MethodDrug Therapy, CombinationEarly Termination of Clinical TrialsFemaleHumansHydrocortisoneLength of StayMaleMiddle AgedOrgan Dysfunction ScoresRespiration, ArtificialRespiratory InsufficiencySepsisThiamineTreatment OutcomeVasoconstrictor AgentsVitaminsConceptsVasopressor-free daysIntensive care unitVitamin CPlacebo groupCare unitIntervention groupDays of randomizationIntravenous vitamin CPlacebo-controlled trialThirty-day mortalityTotal daily doseKey secondary outcomesAdult patientsSecondary outcomesDaily doseIll patientsPrimary outcomeSubstantial morbidityCardiovascular dysfunctionEmergency departmentCommon syndromeMAIN OUTCOMESepsisPlaceboPatientsF-Actin is associated with a worsening qSOFA score and intensive care unit admission in emergency department patients at risk for sepsis
Belsky JB, Filbin MR, Rivers EP, Bobbitt KR, Jaehne AK, Wisnik CA, Maciejewski KR, Li F, Morris DC. F-Actin is associated with a worsening qSOFA score and intensive care unit admission in emergency department patients at risk for sepsis. Biomarkers 2020, 25: 391-396. PMID: 32421363, DOI: 10.1080/1354750x.2020.1771419.Peer-Reviewed Original ResearchConceptsIntensive care unitEmergency departmentQSOFA scoreIllness severityPlasma levelsThymosin beta 4Quick Sequential Organ Failure Assessment (qSOFA) scoreSequential Organ Failure Assessment scoreIntensive care unit admissionOrgan Failure Assessment scoreCare unit admissionPositive urine cultureSymptoms of sepsisSystemic inflammatory syndromeDiagnosis of sepsisEmergency department patientsSignificant outcome measureBeta 4Unit admissionICU admissionInflammatory syndromeDepartment patientsSeptic shockCare unitED patientsAntibiotic Delays and Feasibility of a 1-Hour-From-Triage Antibiotic Requirement: Analysis of an Emergency Department Sepsis Quality Improvement Database
Filbin MR, Thorsen JE, Zachary TM, Lynch JC, Matsushima M, Belsky JB, Heldt T, Reisner AT. Antibiotic Delays and Feasibility of a 1-Hour-From-Triage Antibiotic Requirement: Analysis of an Emergency Department Sepsis Quality Improvement Database. Annals Of Emergency Medicine 2019, 75: 93-99. PMID: 31561998, DOI: 10.1016/j.annemergmed.2019.07.017.Peer-Reviewed Original ResearchConceptsQuality improvement interventionsHours of triageAntibiotic delaySeptic patientsImprovement interventionsAntibiotic requirementsLower Sequential Organ Failure Assessment scoresSequential Organ Failure Assessment scoreMedicaid Services Severe SepsisOrgan Failure Assessment scoreSurviving Sepsis Campaign recommendationsMost septic patientsOnset of hypoperfusionSurviving Sepsis CampaignAdult septic patientsQuality improvement databaseNational quality measuresMedicaid Services measuresTriage locationInfectious symptomsSevere sepsisChart reviewMost patientsSepsis CampaignPrimary outcomeA review of micronutrients in sepsis: the role of thiamine, l-carnitine, vitamin C, selenium and vitamin D
Belsky JB, Wira CR, Jacob V, Sather JE, Lee PJ. A review of micronutrients in sepsis: the role of thiamine, l-carnitine, vitamin C, selenium and vitamin D. Nutrition Research Reviews 2018, 31: 281-290. PMID: 29984680, DOI: 10.1017/s0954422418000124.Peer-Reviewed Original ResearchConceptsVitamin CLife-threatening organ dysfunctionRole of micronutrientsCurrent available dataSeptic patientsOrgan dysfunctionSeptic shockVitamin DVitamin D.Clinical trialsRole of thiamineThiamine deficiencySepsisHuman studiesHost responseConclusion statementsCellular dysfunctionNormal physiologyMetabolic demandsCarnitinePotential roleDysfunctionPresent reviewCellular turnoverPivotal roleThymosin beta 4 regulation of actin in sepsis
Belsky JB, Rivers EP, Filbin MR, Lee PJ, Morris DC. Thymosin beta 4 regulation of actin in sepsis. Expert Opinion On Biological Therapy 2018, 18: 193-197. PMID: 29508629, PMCID: PMC6556887, DOI: 10.1080/14712598.2018.1448381.Peer-Reviewed Original ResearchConceptsThymosin beta 4Beta 4Life-threatening organ damageAnti-inflammatory genesAnti-inflammatory propertiesComprehensive literature searchMicrocirculatory perturbationsInflammatory mediatorsOrgan damageSepsis resultsSeptic ratsClinical trialsSepsisAnti-oxidative enzymesHost responseLiterature searchAnti-apoptotic enzymesReactive oxygen speciesDecreased concentrationMeasurable levelsMortalityCurrent knowledgeOxygen speciesBinding proteinPatientsEarly goal-directed therapy in severe sepsis and septic shock: insights and comparisons to ProCESS, ProMISe, and ARISE
Nguyen HB, Jaehne AK, Jayaprakash N, Semler MW, Hegab S, Yataco AC, Tatem G, Salem D, Moore S, Boka K, Gill JK, Gardner-Gray J, Pflaum J, Domecq JP, Hurst G, Belsky JB, Fowkes R, Elkin RB, Simpson SQ, Falk JL, Singer DJ, Rivers EP. Early goal-directed therapy in severe sepsis and septic shock: insights and comparisons to ProCESS, ProMISe, and ARISE. Critical Care 2016, 20: 160. PMID: 27364620, PMCID: PMC4929762, DOI: 10.1186/s13054-016-1288-3.Peer-Reviewed Original ResearchConceptsEarly goal-directed therapyGoal-directed therapySeptic shockSevere sepsisSepsis mortalitySepsis managementSignificant mortality reductionSurviving Sepsis CampaignAcute myocardial infarctionStandard of careEarly sepsis managementHemodynamic pathogenesisUsual careSepsis CampaignStandard careEmergency departmentMyocardial infarctionEarly managementOutcome benefitsClinical trialsMortality reductionTherapyMortalityTrialsCare
Clinical Trials
Current Trials
Crystalloid Liberal or Vasopressors Early Resuscitation in Sepsis (CLOVERS)
HIC ID2000023369RoleSub InvestigatorPrimary Completion Date05/04/2022Recruiting ParticipantsGenderBothAge18+ years
Academic Achievements & Community Involvement
Clinical Care
Overview
Justin Belsky, MD, is an emergency medicine specialist who focuses on diagnosing and treating sepsis, a serious illness that can occur when the body reacts severely to an infection, as well as other urgent medical conditions.
“My goal is to provide a platform to diagnose patients with serious bacterial infections prior to organ damage and to risk stratify those who are sick,” Dr. Belsky says.
As an assistant professor of emergency medicine at Yale School of Medicine, Dr. Belsky conducts research aimed at improving the care of patients with severe infections. He served as the Yale site principal investigator for a multicenter clinical trial exploring combination therapy for patients with septic shock.
He completed his medical training at Wayne State University School of Medicine, followed by a residency in emergency medicine at Henry Ford Hospital and a research fellowship at Massachusetts General Hospital.
Clinical Specialties
Emergency Medicine
Board Certifications
Emergency Medicine
- Certification Organization
- AB of Emergency Medicine
- Original Certification Date
- 2015