2024
A practical magnetic-resonance imaging score for outcome prediction in comatose cardiac arrest survivors
Chan W, Nguyen C, Kim N, Tripodis Y, Gilmore E, Greer D, Beekman R. A practical magnetic-resonance imaging score for outcome prediction in comatose cardiac arrest survivors. Resuscitation 2024, 202: 110370. PMID: 39178939, DOI: 10.1016/j.resuscitation.2024.110370.Peer-Reviewed Original ResearchHypoxic-ischemic brain injuryDeep gray nucleiArea under the receiver operating curveMagnetic resonance imagingMagnetic Resonance Imaging ScorePoor neurological outcomeCerebral Performance CategoryIntra-class correlationNeurological outcomeMRI scoreCardiac arrestComatose CA survivorsCA survivorsComatose cardiac arrest survivorsPredicting neurologic outcomeCardiac arrest survivorsInter-rater reliabilityReceiver operating curveAcademic medical centerMedian timePoor outcomePrognostic toolGray nucleiArrest survivorsScore groupTemperature Control Parameters Are Important: Earlier Preinduction Is Associated With Improved Outcomes Following Out-of-Hospital Cardiac Arrest
Beekman R, Kim N, Nguyen C, McGinniss G, Deng Y, Kitlen E, Garcia G, Wira C, Khosla A, Johnson J, Miller P, Perman S, Sheth K, Greer D, Gilmore E. Temperature Control Parameters Are Important: Earlier Preinduction Is Associated With Improved Outcomes Following Out-of-Hospital Cardiac Arrest. Annals Of Emergency Medicine 2024, 84: 549-559. PMID: 39033449, DOI: 10.1016/j.annemergmed.2024.06.007.Peer-Reviewed Original ResearchOut-of-hospital cardiac arrestNeurological outcomeDevice cohortCardiac arrestOut-of-hospital cardiac arrest patientsConsecutive out-of-hospital cardiac arrestPreinduction timeInterquartile rangeAssociated with improved outcomesCardiac arrest patientsProportion of patientsMultivariate logistic regression modelInverse probability of treatmentDevice timeInverse probability treatment weightsProbability of treatmentProspective trialsOHCA patientsArrest patientsClinical outcomesLogistic regression modelsCenter studyEarly initiationSecondary outcomesTreatment weightingCan Clinical Scores Predict the Presence of Hypoxic Ischemic Brain Injury on Early Head Computed Tomography After Cardiac Arrest? (P6-2.001)
Nguyen C, Molligoda B, Kim N, Kitlen E, Wira C, Perman S, Khosla A, Miller P, Greer D, Gilmore E, Beekman R. Can Clinical Scores Predict the Presence of Hypoxic Ischemic Brain Injury on Early Head Computed Tomography After Cardiac Arrest? (P6-2.001). Neurology 2024, 102 DOI: 10.1212/wnl.0000000000206255.Peer-Reviewed Original ResearchThe Impact of Socioeconomic Status on Risk for Brain Death Following Out-of-Hospital Cardiac Arrest (P1-4.014)
Fung C, Kitlen E, Nguyen C, Kim N, Wira C, Perman S, Khosla A, Miller P, Greer D, Gilmore E, Beekman R. The Impact of Socioeconomic Status on Risk for Brain Death Following Out-of-Hospital Cardiac Arrest (P1-4.014). Neurology 2024, 102 DOI: 10.1212/wnl.0000000000206574.Peer-Reviewed Original Research
2023
Abstract 145: Deploying Early Cooling at ICECAP Sites: A Barrier Assessment
Beekman R, Kline P, Yeatts S, Geocadin R, Silbergleit R, Meurer W. Abstract 145: Deploying Early Cooling at ICECAP Sites: A Barrier Assessment. Circulation 2023, 148: a145-a145. DOI: 10.1161/circ.148.suppl_1.145.Peer-Reviewed Original ResearchBarriers to early initiationIntensive care unit transferCardiac arrest patientsNurse availabilityProvider educationControl practicesIdentified barriersElectronic surveyBarrier assessmentQuality improvementArrest patientsEducational initiativesInstitutional protocolUnit transferPrincipal investigatorCardiac arrestSurvivors of cardiac arrestBoarding timeStandard sedationBest practicesAverage boarding timeEarly initiationComatose survivors of cardiac arrestEarly coolingDevelopment of sedativesTemperature Control in the Era of Personalized Medicine: Knowledge Gaps, Research Priorities, and Future Directions
Beekman R, Khosla A, Buckley R, Honiden S, Gilmore E. Temperature Control in the Era of Personalized Medicine: Knowledge Gaps, Research Priorities, and Future Directions. Journal Of Intensive Care Medicine 2023, 39: 611-622. PMID: 37787185, DOI: 10.1177/08850666231203596.Peer-Reviewed Original ResearchHypoxic-ischemic brain injuryCardiac arrestPopulation-based thresholdsDuration of therapyCardiac arrest survivorsCause of deathRobust preclinical evidencePatient-centered careCritical future stepNeurologic outcomeNeuroprotective therapiesPreclinical evidenceArrest survivorsClinical equipoiseBrain injuryCurrent guidelinesFever preventionIndividualized targetOnly interventionTherapeutic windowInsufficient evidenceResearch prioritiesPersonalized approachMetabolic demandsCore temperatureDevelopment and validation of a novel score to predict brain death after out-of-hospital cardiac arrest
Kitlen E, Kim N, Rubenstein A, Keenan C, Garcia G, Khosla A, Johnson J, Miller P, Wira C, Greer D, Gilmore E, Beekman R. Development and validation of a novel score to predict brain death after out-of-hospital cardiac arrest. Resuscitation 2023, 192: 109955. PMID: 37661012, DOI: 10.1016/j.resuscitation.2023.109955.Peer-Reviewed Original ResearchConceptsHospital cardiac arrestBrain deathCardiac arrestOptimal cutEtiology of arrestDeath risk scoreNon-shockable rhythmOperator characteristic curveHours of arrestCenter cohortIndependent predictorsSulcal effacementUnResponsiveness (FOUR) scoreValidation cohortDevelopment cohortMAIN OUTCOMEHigh riskRisk scoreAcademic centersNovel scoreOHCACohortInternal validationRadiology reportsCharacteristic curveValidation of the rCAST score and comparison to the PCAC and FOUR scores for prognostication after out-of-hospital cardiac arrest
Kim N, Kitlen E, Garcia G, Khosla A, Miller P, Johnson J, Wira C, Greer D, Gilmore E, Beekman R. Validation of the rCAST score and comparison to the PCAC and FOUR scores for prognostication after out-of-hospital cardiac arrest. Resuscitation 2023, 188: 109832. PMID: 37178901, DOI: 10.1016/j.resuscitation.2023.109832.Peer-Reviewed Original ResearchConceptsPoor neurologic outcomeUnited States cohortHospital cardiac arrestOHCA patientsNeurologic outcomeCardiac arrestPost-cardiac arrest syndromePoor neurological outcomeScore predictive abilityHospital mortalityNeurological outcomeUnResponsiveness (FOUR) scorePoor outcomeRetrospective studyAccurate outcome predictionPrognostic performanceFull OutlineDeLong testOutcome predictionPatientsMortalityOutcomesScoresCohortPredictive abilityBrain imaging after cardiac arrest
Beekman R, Hirsch K. Brain imaging after cardiac arrest. Current Opinion In Critical Care 2023, 29: 192-198. PMID: 37078612, DOI: 10.1097/mcc.0000000000001032.Peer-Reviewed Original ResearchConceptsCardiac arrestComputed tomographyLong-term neurological outcomeQuantitative analysis of CTPrediction of long-term neurologic outcomeInterpretation of CTAnalysis of CTInterpreting CTBrain imagingNovel imaging techniquesNeurological outcomePoor outcomeDisorders of consciousnessNeurological injuryLack of specificityMRIInter-rater reliabilityQuantitative image analysisArrestOutcomesImaging techniquesBrainMultimodal assessmentMethodological limitationsPatients
2022
Emergency department initiated resuscitative endovascular balloon occlusion of the aorta (REBOA) for out‐of‐hospital cardiac arrest is feasible and associated with improvements in end‐tidal carbon dioxide
Daley J, Buckley R, Kisken KC, Barber D, Ayyagari R, Wira C, Aydin A, Latich I, Lozada JCP, Joseph D, Marino A, Mojibian H, Pollak J, Chaar CO, Bonz J, Belsky J, Coughlin R, Liu R, Sather J, Van Tonder R, Beekman R, Fults E, Johnson A, Moore C. Emergency department initiated resuscitative endovascular balloon occlusion of the aorta (REBOA) for out‐of‐hospital cardiac arrest is feasible and associated with improvements in end‐tidal carbon dioxide. Journal Of The American College Of Emergency Physicians Open 2022, 3: e12791. PMID: 36176506, PMCID: PMC9463569, DOI: 10.1002/emp2.12791.Peer-Reviewed Original ResearchAdvanced cardiac life supportResuscitative endovascular balloon occlusionEnd-tidal carbon dioxideHospital cardiac arrestEndovascular balloon occlusionAortic occlusionCardiac life supportOHCA patientsBalloon occlusionCardiac arrestEmergency departmentLife supportAcademic urban EDEarly feasibility trialUrban ED settingIntra-aortic balloonTidal carbon dioxideReperfusion strategyHospital admissionSpontaneous circulationUrban EDED settingFeasibility trialBalloon deflationChest compressionsOxygen Supplementation and Hyperoxia in Critically Ill Cardiac Patients From Pathophysiology to Clinical Practice
Thomas A, van Diepen S, Beekman R, Sinha SS, Brusca SB, Alviar CL, Jentzer J, Bohula EA, Katz JN, Shahu A, Barnett C, Morrow DA, Gilmore EJ, Solomon MA, Miller PE. Oxygen Supplementation and Hyperoxia in Critically Ill Cardiac Patients From Pathophysiology to Clinical Practice. JACC Advances 2022, 1: 100065. PMID: 36238193, PMCID: PMC9555075, DOI: 10.1016/j.jacadv.2022.100065.Peer-Reviewed Reviews, Practice Guidelines, Standards, and Consensus StatementsOxygen supplementationIntensive care unit cliniciansHarmful hemodynamic effectsAdverse clinical outcomesIll cardiac patientsManagement of patientsAcute cardiac diseaseAcute myocardial infarctionDirect cellular toxicityCoronary vasoconstrictionPulmonary hypertensionRespiratory failureHemodynamic effectsHeart failureOxygen therapyClinical outcomesSupplemental oxygenAvailable trialsCardiac arrestMyocardial infarctionCardiac patientsCardiac diseaseClinical practiceCardiovascular systemHyperoxiaBedside monitoring of hypoxic ischemic brain injury using low-field, portable brain magnetic resonance imaging after cardiac arrest
Beekman R, Crawford A, Mazurek MH, Prabhat AM, Chavva IR, Parasuram N, Kim N, Kim JA, Petersen N, de Havenon A, Khosla A, Honiden S, Miller PE, Wira C, Daley J, Payabvash S, Greer DM, Gilmore EJ, Kimberly W, Sheth KN. Bedside monitoring of hypoxic ischemic brain injury using low-field, portable brain magnetic resonance imaging after cardiac arrest. Resuscitation 2022, 176: 150-158. PMID: 35562094, PMCID: PMC9746653, DOI: 10.1016/j.resuscitation.2022.05.002.Peer-Reviewed Original ResearchConceptsCardiac arrestBrain injuryHypoxic-ischemic brain injuryAdverse neurological outcomesIschemic brain injurySingle-center studyBrain magnetic resonanceBrain injury severityBoard-certified neuroradiologistsLow-field MRIFLAIR signal intensityNeurological outcomeCA patientsIll patientsMRI findingsCA survivorsCenter studyMRI examinationsClinical careHigh riskInjury severityPatientsSignal intensityBedside monitoringMR imaging
2021
Neuromonitoring After Cardiac Arrest Can Twenty-First Century Medicine Personalize Post Cardiac Arrest Care?
Beekman R, Maciel CB, Balu R, Greer DM, Gilmore EJ. Neuromonitoring After Cardiac Arrest Can Twenty-First Century Medicine Personalize Post Cardiac Arrest Care? Neurologic Clinics 2021, 39: 273-292. PMID: 33896519, DOI: 10.1016/j.ncl.2021.01.002.Peer-Reviewed Original ResearchConceptsSecondary brain injuryCardiac arrest careBrain injuryArrest carePost-cardiac arrest syndromeHypoxic-ischemic brain injuryPost-cardiac arrest careEtiology of arrestSecondary neurologic injuryCardiac arrest survivorsNeurologic comorbiditiesNeuromonitoring toolsNeurologic injuryArrest survivorsCardiac arrestNeuromonitoring techniquesCerebral physiologyPhysiologic variablesIndividualized approachRisk profileInjuryHeterogeneous populationCareArrestComorbidities
2019
Differential outcomes following successful resuscitation in cardiac arrest due to drug overdose
Ormseth CH, Maciel CB, Zhou SE, Barden MM, Miyares LC, Beekman RB, Gilmore EJ, Greer DM. Differential outcomes following successful resuscitation in cardiac arrest due to drug overdose. Resuscitation 2019, 139: 9-16. PMID: 30965094, DOI: 10.1016/j.resuscitation.2019.04.004.Peer-Reviewed Original ResearchConceptsCardiac arrestNeurological recoveryClinical characteristicsDrug overdoseBrain deathCerebral Performance Category scoreCA casesFavorable neurological recoverySimilar neurological recoveryLarge prospective studiesPositive toxicology screenRankin Scale scorePotential treatment optionSingle academic institutionBystander cardiopulmonary resuscitationHospital dischargeInpatient mortalitySuccessful resuscitationToxicology screenProspective studyTreatment optionsMedical recordsMedication administrationCardiopulmonary resuscitationRetrospective analysisDistinct predictive values of current neuroprognostic guidelines in post-cardiac arrest patients
Zhou SE, Maciel CB, Ormseth CH, Beekman R, Gilmore EJ, Greer DM. Distinct predictive values of current neuroprognostic guidelines in post-cardiac arrest patients. Resuscitation 2019, 139: 343-350. PMID: 30951843, PMCID: PMC6589093, DOI: 10.1016/j.resuscitation.2019.03.035.Peer-Reviewed Original ResearchConceptsPost-cardiac arrest patientsAmerican Heart AssociationArrest patientsPredictive valueDiffuse hypoxic-ischemic injurySingle tertiary care centerDistinct predictive valuesHypoxic-ischemic injuryOutcomes of patientsTertiary care centerLife-sustaining therapyIntensive care medicineFalse positive rateAAN guidelinesAHA guidelinesHospital recordsCardiac arrestHeart AssociationCare centerCurrent guidelinesCare medicineBetter outcomesBiochemical findingsPatientsAmerican Academy