NIH awards K23 grant to study effects of carbon dioxide levels after cardiac arrest

The NIH-National Heart Lung and Blood Institute has awarded Brian W. Roberts, MD, emergency medicine physician at Cooper University Health Care and Assistant Professor of Emergency Medicine at Cooper Medical School of Rowan University (CMSRU), a Mentored Patient-Oriented Career Development grant (K23) to study post-resuscitation partial pressure of arterial carbon dioxide and neurological outcome after cardiac arrest. The grant which will total more than $630,000 is an ancillary study built upon the previously awarded RO1 grant also awarded in 2013 from the NIH to Stephen W. Trzeciak, MD, Head of the Division of Critical Care Medicine at Cooper University Health Care and Associate Professor of Medicine and Emergency Medicine at CMSRU, to study neurological and cognitive effects of hyperoxia after cardiac arrest.

The study will be a six-center prospective observational study. The research will examine patients who have cardiac arrest, receive CPR, and are successfully revived, but remain on a ventilator after CPR.

"Patients who receive CPR frequently have brain damage because of the lack of oxygen delivered to the brain while the heart was not beating on its own," states Dr. Roberts. "We will be looking to see if there is an association between the level of carbon dioxide in the blood after CPR and the degree of brain injury after CPR."

Previous research has shown that carbon dioxide levels in the blood have been shown to affect the amount of blood flow delivered to the brain; low carbon dioxide levels decrease blood flow and high levels increase blood flow. Physicians can control the level of carbon dioxide in the blood when a patient is on a ventilator by controlling how fast a patient breathes and thus how much carbon dioxide they breath out.

Dr. Roberts explains, "It is possible that during the initial period after the heart starts again the injured brain is at risk for additional injury from either too little or too much blood flow. We are looking for the optimal level of carbon dioxide which is associated with the least amount of brain injury. If we identify an optimal carbon dioxide range then physicians can aim for this range with the hope of decreasing brain injury after cardiac arrest and improve the patient's outcome."

"Cooper is internationally known for its critical care, trauma, and emergency medicine programs," says Paul Katz, MD, Dean of CMSRU. "We are proud of Dr. Roberts for continuing this tradition of advancing medical knowledge and improving patient care for the critically ill, and we're grateful to the NIH for recognizing the importance of this research."

Dr. Roberts' primary mentor on the grant is Dr. Trzeciak; and intramural co-mentors include R. Phillip Dellinger, MD, Chief of the Department of Medicine at Cooper University Health Care and Chair of the Department of Medicine at CMSRU, and Steven M. Hollenberg, MD, Director of the Coronary Care Unit at Cooper and Professor of Medicine at CMSRU.

A NIH Career Development Grant allows the researcher to work towards obtaining the skills required to become an independent investigator and apply an independent research grant (R01) at the end of the five years. The mentor team helps to guide the investigator through this multi-center project. Dr. Roberts will be working towards a Master's of Science in Clinical Research and Translational Medicine at Temple University.