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Divisions and Programs

Neurocritical Care


Division Chief: Joshua Levine, MD

Link to Penn Medicine Website: Neurocritical Care

The Neurocritical Care Division is focused on advancing innovative clinical, translational, and basic science research to improve outcomes for patients with severe neurologic injury. Research programs span traumatic brain injury, subarachnoid hemorrhage, cardiac arrest, ischemic and hemorrhagic stroke, and status epilepticus, with an emphasis on understanding disease mechanisms and developing novel therapies. Key areas of investigation include advanced brain monitoring technologies, biomarkers and prognostic tools for traumatic brain injury, coagulation and inflammatory pathways after neurologic injury, long-term outcomes after cardiac arrest, and the use of bioinformatics to optimize NeuroICU care. The division also participates in numerous clinical trials that provide patients with access to cutting-edge therapies for acute neurologic diseases. Research efforts are supported through specialized programs and collaborations, including the Penn Acute Research Collaboration (PARC), the Center for Brain Injury and Repair, and the RECOVER Program.

 

The Neurocritical Care Division has research programs that focus on:

  • The optimal use of advanced technology to monitor brain physiology and function in patients with severe brain injury
  • Better understanding determinants of long-term outcome after traumatic brain injury (TBI)
  • Better understanding disturbances in coagulation (blood clotting) and inflammation after traumatic brain injury and subarachnoid hemorrhage
  • Developing biomarkers that might be used in clinical trials and for prognosis in traumatic brain injury
  • Better understanding determinants of long-term outcome in survivors of cardiac arrest
  • The optimal use of bioinformatics in the care of patients in the NeuroICU

Centers and Programs

Labs

  • Diaz Arrastia Lab
    Dr. Ramon Diaz-Arrastia, a world expert in traumatic brain injury, runs a lab that is focused on understanding the endophenotypes of traumatic brain injury (TBI), with the goals of developing biomarkers that can inform the design of targeted therapies for patients with TBI, and reducing secondary injury during the acute period and promoting repair and regeneration during the subacute and chronic stages.  His most recent research efforts are directed at using magnetic resonance imaging, near infrared spectroscopy, and blood biomarkers to measure traumatic microvascular injury, track the evolution of traumatic microvasculopathy as patients recover from TBI, and develop predictive and pharmacodynamics biomarkers that can be useful for improving the next generation of clinical trials for brain injury.

  • Fischer Lab
    Through the coordination of clinical care and research, the RECOVER Program ensures that each informs and optimizes the other: its research questions are grounded in the realities of patient care, research can be conducted more rigorously through the program's systematic model of care, and cutting-edge techniques developed by research can be rapidly and ethically translated to patients and families.

Clinical Trials

The TBIRI team is conducting studies using a wide variety of modalities to assess and treat traumatic brain injuries. These include medications (oral, inhaled, IV, etc.) as well as the use of tests/devices to aid in diagnosis or assess the impact of treatment.  The Division currently has 3 active industry clinical trials and several others with funding from DOD and NIH.  These trials are directed by Ramon Diaz-Arrastia, Danielle Sandsmark with support from the University PARC (Penn Acute Research Collaboration) team.  PARC, defined operationally as research into time-sensitive conditions with the need for rapid screening and enrollment at all times, “Any enrollment, any time”.  ACR collaborative structures are rare in U.S. academic medical centers