Medical Student Research Fellowship for Summer 2006
Mentor: Ahamed H. Idris, MD
Department: Surgery (Emergency Medicine)
Room number: CS 2.102
Mail Code: 8579
Phone number: 214-648-4812
E-mail: ahamed.idris@utsouthwestern.edu
Project title: Evaluation of an Inspiratory Impedance Threshold Device (ITD) in the Emergency Department for the Treatment of Hypotension
Human subjects IRB approved project number (where applicable): 012005-065
Project Type (patient-based research
Brief Description of Project:
The purpose of the study to determine if the Impedance Threshold Device (ITD) attached to a facemask or mouthpiece can increase blood pressure in patients who present to the emergency department with hypotension secondary to hypovolemia or relative hypovolemia. The cause of hypovolemia could be trauma, blood loss from other causes, sepsis, or dehydration; each a common medical problem for the military. The study is designed to test the hypothesis that use of the active ITD will result in a rapid rise in blood pressure secondary to an increase in cardiac output. Either an active or sham ITD will be applied to hypotensive patients when initially presented to the emergency department with a systolic blood pressure of <95 mmHg. The main endpoint of this portion of the study will be the rise in blood pressure over the first 10 minutes of time. Based upon the animal studies as well as clinical studies performed to date, we hypothesize that use of the active ITD will result in a more rapid and higher blood pressure than the sham ITD. Multiple additional clinical parameters will also be compared between the two groups of patients.
Project title: Resuscitation Outcomes Consortium REGISTRY
Human subjects IRB approved project number (where applicable): 102005-054
Project Type (patient-based research
Brief Description of Project:
Overview of the Resuscitations Outcomes Consortium (ROC)
The Resuscitation Outcomes Consortium was established in 2004 by the National Heart Lung and Blood Institute of the National Institute of Health, in partnership with the Institute of Circulatory Respiratory Health of the Canadian Institutes of Health Research and other agencies. The goal of the ROC is to conduct clinical research in the areas of cardiopulmonary arrest and life-threatening traumatic injury. The ROC has the necessary infrastructure to conduct multiple randomized trials to aid rapid translation of promising scientific and clinical advances to improve resuscitation outcomes.
Purpose of Registry
1. To establish a comprehensive ongoing data infrastructure to facilitate the
design, implementation and interpretation of Resuscitation Outcomes Consortium
(ROC) trials.
2. To define the incidence and outcome of out-of-hospital cardiac arrest and
life-threatening traumatic injury.
3. To describe the relationships between resuscitation performance and EMS structure,
adjusting for episode-specific factors.
4. To evaluate the relationships between outcome and patient, EMS, regional,
and periodic factors.
Project title: Neurological Assessments and Outcomes in Patients Surviving Cardiopulmonary Resuscitation, and the Impact and Efficacy of Resuscitation Interventions
Human subjects IRB approved project number (where applicable): 032006-107
Project Type patient-based research
Brief Description of Project:
The purpose of the study is to refine the type and timing of neurological assessment tools used to determine neurological outcome in people who have survived cardiac arrest and to determine the feasibility of using telephone, mail, and chart-review for obtaining particular neurological outcome measures.
Project title:A PROSPECTIVE STUDY OF THE TIME INTERVAL FROM ACTIVATION OF THE CODE BLUE TEAM TO THE FIRST DEFIBRILLATION SHOCK FOR CARDIAC ARREST.
Human subjects IRB approved project number (where applicable): 0603-423
Project Type patient-based research
Brief Description of Project:
Purpose
1. To measure the time interval from placement of a call for the code blue
team to the first defibrillation shock given for patients having ventricular
tachycardia or fibrillation.
2. To determine the relationship between the call-to-shock time interval, survival
from cardiac arrest, and neurological outcome.
Previous Research Activities or Publications with Medical Students:
Peer-reviewed publications (Student author is underlined)
1. Schiff RL, Ansell DA, Schlosser JE, Idris AH, Morrison A, Whitman S. Transfers to a Public Hospital: A Prospective Study of 467 Patients. N Engl J Med 1986;314:552-557.
2. Idris AH, Becker LB, Wenzel V, Fuerst R, Gravenstein N. Lack of uniform definitions and reporting in laboratory models of cardiac arrest: A review of the literature and a proposal for guidelines. Annals of Emergency Medicine 1994;23:9-16.
3. Tucker KJ, Idris AH, Wenzel V, Orban DJ. Changes in arterial and mixed venous blood gases during untreated ventricular fibrillation and cardiopulmonary resuscitation. Resuscitation 1994;28:137-141.
4. Idris AH, Becker LB, Fuerst RS, Wenzel V, Rush WJ, Melker RJ, Orban DJ. Effect of ventilation on resuscitation in an animal model of cardiac arrest. Circulation 1994;90:3063-3069.
5. Wenzel V, Idris AH, Banner MJ, Fuerst RS, Tucker KJ. The Composition of Gas Given by Mouth-to-Mouth Ventilation During CPR. Chest 1994;106:1806-1810.
6. Idris AH, Banner MJ, Wenzel V, Fuerst RS, V, Becker LB, Melker RJ. Ventilation caused by external chest compression is unable to sustain effective gas exchange during CPR: a comparison with mechanical ventilation. Resuscitation 1994;28:143-150.
7. Wenzel V, Fuerst RS, Idris AH, Banner MJ, Rush WJ, Orban DJ. A model for studying mechanical active compression/decompression cardiopulmonary resuscitation. Annals of Emergency Medicine 1995;25:386-389.
8. Idris AH, Wenzel V, Becker L, Banner M, Orban D. Does hypercarbia or hypoxia independently affect resuscitation from cardiac arrest? Chest 1995;108:522-528.
9. Wenzel V, Lehmkuhl P, Kubilis PS, Idris AH, Pichlmayr I. Poor coorelation of mouth-to-mouth ventilation skills after basic life support training and 6 months later. Resuscitation 1997;35:129-134.
10. Kissoon N, Idris A, Wenzel V, Murphey S, Rush W. Intraosseous and central venous blood acid-base relationship during cardiopulmonary resuscitation. Pediatric Emerg Care 1997;13:250-253.
11. Wenzel V, Idris AH, Banner MJ, Kubilis PS, Williams, Jr. JL Influence of tidal volume on the distribution of gas between the lungs and stomach in the unintubated patient receiving positive-pressure ventilation. Crit Care Med 1998;26:364-368.
12. Wenzel V, Idris AH, Banner MJ, Kubilis PS, Williams, Jr. JL . Respiratory system compliance decreases after cardiopulmonary resuscitation and stomach inflation: Impact of large and small tidal volumes on calculated peak airway pressure. Resuscitation 1998;38:113-118.
13. Wenzel V, Idris AH, et al. A survey of effects of anesthesia protocols in porcine cardiopulmonary resuscitation laboratory models on prearrest hemodynamic variables. Comparative Medicine 2000;50:584-588.
14. Layon AJ, Gabrielli A, Goldfeder BW, Hevia A, Idris AH. Utstein style analysis of rural out of hospital cardiac arrest (OOHCA): Total cardiopulmonary resuscitation (CPR) time inversely correlates with hospital discharge rate. Resuscitation. 2003;56(1):59-66.
15. Idris AH, Berg R, Bierens J, Bossaert L, Branche C, Gabrielli A, Graves SA, Handley AJ, Hoelle R, Morley P, Papa L, Pepe P, Quan L, Szpilman D, Wigginton J, Modell JH. Recommended Guidelines for Uniform Reporting of Data from Drowning: The 'Utstein Style'. Resuscitation 2003;59:45-57. Co-published in Circulation 2003;
16. Convertino V, Ratliff D, Ryan KL, Doerr DF, Ludwig DA, Muniz GW, Britton DL, Clah SD, Fernald KB, Ruiz AF, Lurie KG, and Idris AH. Hemodynamics Associated with Breathing Through an Inspiratory Impedance Threshold Device in Human Volunteers. Crit Care Med 2004;32(Suppl.):S381-S386.
17. Papa L, Hoelle R, Idris AH. Systematic review of definitions used to describe drowning. Resuscitation 2005;65:255-264.
18. Convertino V, Ratliff D, Crissey J, Doerr DF, Idris A, Lurie KG. Effects of inspiratory impedance on hemodynamic responses to a squat-stand test in human volunteers: implications for treatment of orthostatic hypotension. Eur J Appl Physiol 2005;94:392-399.
19. Idris AH, Gabrielli A, Caruso L, Showstark M, Layon AJ, Becker LB, Vanden Hoek T, Hevia A, Roberts II J. Oxidant injury occurs rapidly after cardiac arrest, cardiopulmonary resuscitation, and reperfusion. Crit Care Med 2005;33:2043-2048.
Abstracts:
1. Wenzel V, Idris AH, Fuerst R, Becker L, Orban D. Lack of standards in animal CPR research. Annals of Emergency Medicine 1993;22:929.
2. Fuerst R, Idris AH, Banner M, Wenzel V, Orban D. Changes in respiratory system compliance during cardiopulmonary arrest with and without closed chest compressions. Annals of Emergency Medicine 1993;22:931.
3. Idris AH, Fuerst RS, Wenzel V, Becker LB, Orban DJ, Banner MJ. Does hypoxia or hypercarbic acidosis independently affect survival from cardiac arrest? Circulation 1993;88 (Suppl):I-225.
4. Idris AH , Orban D, Fuerst R, Becker L, Rush W, Wenzel V. The relationship of End-tidal CO2 and Coronary Artery Perfusion Pressure Following Administration of Epinephrine During CPR. Academic Emergency Medicine 1994;1:309.
5. Wenzel V, Idris AH, Banner MJ, Fuerst RS, Orban DJ. Exhaled gas composition of mouth-to-mouth ventilation during cardiopulmonary resuscitation (CPR). Critical Care Medicine 1994;22:A-133.
6. Idris AH, Wenzel V, Tucker KJ, Orban DJ. Chest compression ventilation: A comparison of standard CPR and active-compression/decompression CPR. Academic Emergency Medicine 1994;1:A17.
7. Kissoon N, Idris A, Wenzel V, Peterson R, Murphy S, Rush W. Comparison of the acid-base balance of intraosseous and mixed venous blood gases during cardiopulmonary resuscitation. Pediatric Research 1994; 35:310.
8. Kissoon N, Idris A, Wenzel V, Peterson R, Rush W. Comparison of the acid-base balance of intraosseous and mixed venous blood gases during cardiopulmonary resuscitation. Clinical and Investigative Medicine 1994;17:17.
9. Wenzel V, Fuerst RS, Idris AH, Banner MJ, Rush WJ, Orban DJ. Automatic mechanical device to standardize active compression-decompression cardiopulmonary resuscitation. Resuscitation 1994;28:S6.
10. Idris AH, Wenzel V, Banner MJ, Melker RJ. Smaller tidal volumes minimize gastric inflation during CPR with an unprotected airway. Circulation 1995;92(Suppl 1):759-760.
11. Wenzel V, Idris AH, Banner MJ, Williams JL Jr., Kubilis PS. The influence of pediatric and adult self-inflating bags on gas distribution between the lungs and stomach with an untrotected airway during simulated cardiac arrest. Crit Care Med 1997:25:A59.
12. Wenzel V, Idris AH, Banner MJ, Kubilis PS, Band RA, Williams, Jr. JL . Respiratory system compliance decreases after stomach inflation: Impact of large and small tidal volumes on calculated peak airway pressure. Circulation 1998;98 [suppl]:I-477.
13. Idris AH, Gabrielli A, Caruso L, Showstark M, Layon AJ, Becker LB, Vanden Hoek T, Hevia A, Roberts II J. Oxidant injury occurs rapidly after cardiac arrest, cardiopulmonary resucitation, and reperfusion. Circulation 2000;102 (Suppl II):II-571.
14. Layon AJ, Gabrielli A, Hevia A, Goldfeder BW, Idris A. Utstein style analysis of rural out of hospital cardiac arrest (OOHCA): Total cardiopulmonary resuscitation(CPR) time inversely correlates with hospital discharge rate. Crit Care Med 2000;28:A167.
15. Gabrielli A, Idris AH, Caruso L, Showstark M, Layon AJ, Becker LB, Vanden Hoek T, Hevia A, Roberts II J. Arterial or venous blood may be used to assess oxidant injury after cardiac arrest, cardiopulmonary resucitation, and reperfusion. Academic Emergency Medicine 2001;8:433.
16. Vanden Hoek TL, Kasza KE, Abella B, Zhao D, Jayakar D, Williams U, Padrid P, Idris AH, Wardrip C, Becker LB. Rapid brain and chest cooling during CPR using intravenous and intrapulmonary phase-change ice slurry. Circulation 2002;106 (Suppl II):II-497.
17. Schmalfuss CM, Vanderhoef C, Carlson L, Idris AH. Defibrillator clocks are unable to maintain accurate time over a three-month period. JACC 2003;41(Supp A):337A-338A.
18. Crissey JM, Convertino VA, Ratliff DA, Idris A, Lurie KG. Effects of inspiratory impedance on hemodynamic responses to orthostatic hypotension. Am Soc Gravitational and Space Biology 2004;
19. Roppolo LP, Westfall A, Pepe PE, Idris AH. Assessment of agonal breathing improves detection of cardiac arrest. Circulation 2004;110(Suppl III):III-456.
20. Idris AH, Roppolo LP, Kulkarni H, Ohman K, Pepe PP. A Five-minute Training Program for Automated External Defibrillator Use is More Effective Than a 4-Hour Course. Circulation 2005,112(Suppl II):II-326.
21. Roppolo LP, Ohman K, Pepe PP, Idris AH. The Effectiveness of a Short Cardiopulmonary Resuscitation Course for Laypersons. Circulation 2005; 112(Suppl II):II-325.
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