Neurological emergencies comprise a wide range of conditions which include refractory seizures, acute stroke, traumatic brain and spinal cord injury, meningitis and encephalitis, hypoxic-ischemic encephalopathy, and acute neuromuscular conditions. While these may initially appear to represent disparate conditions, they share two important characteristics: earlier treatment is likely necessary to improve patient outcome and logistics of initial patient presentation pose major challenges to clinical trials of treatments for these conditions. The NINDS Neurological Emergencies Treatment Trials Network will create a national network of hub and spoke hospital systems to facilitate the conduct of streamlined clinical trials for neurological emergencies such as these. We propose SF-NET: the San Francisco Neurological Emergencies Trials network as one of these hub and spoke systems. SF-NET represents a scalable and flexible network of academic and community hospitals which can be configured and activated to maximize enrollment of eligible patients with neurological emergencies in the San Francisco Bay Area, completely covering a catchment area of up to 2 million people depending on the specific condition to be studied. SF-NET builds directly upon the prior successes of clinical trials for neurological emergencies conducted in San Francisco, most prominently the Prehospital Treatment of Status Epilepticus (PHTSE) trial which was conducted via a similar type of network in coordination with SF-EMSA paramedic and ambulance services. San Francisco General Hospital is a trauma center, stroke center, the SF-EMSA base hospital, and serves as the hub of SF-NET. Spoke hospitals include all eight SF-EMSA destination hospitals in San Francisco, all of which previously participated in PHTSE, as well as Alameda County Medical Center Highland Hospital, the trauma center in Oakland, included to enrich SF-NET in neurotrauma. SF-NET will work directly with NINDS and the NETT Clinical Coordinator Center to conduct at least 2 clinical trials of neurological emergencies via the network. Neurological emergencies such as refractory seizures, stroke, and neurotrauma have a major impact on public health and are challenging conditions to study because of the need for early intervention. A network to conduct streamlined trials for these conditions can bring new treatments to clinical care more rapidly.

Agency
National Institute of Health (NIH)
Institute
National Institute of Neurological Disorders and Stroke (NINDS)
Type
Cooperative Clinical Research--Cooperative Agreements (U10)
Project #
5U10NS058931-03
Application #
7631218
Study Section
Special Emphasis Panel (ZNS1-SRB-K (41))
Program Officer
Janis, Scott
Project Start
2007-05-03
Project End
2012-04-30
Budget Start
2009-05-01
Budget End
2010-04-30
Support Year
3
Fiscal Year
2009
Total Cost
$194,117
Indirect Cost
Name
University of California San Francisco
Department
Neurology
Type
Schools of Medicine
DUNS #
094878337
City
San Francisco
State
CA
Country
United States
Zip Code
94143
Claude Hemphill Iii, J (2017) Improving Outcome After Intracerebral Hemorrhage: Maybe It is the Body, Not the Brain. Neurocrit Care 26:157-159
Chan, Sheila; Hemphill 3rd, J Claude (2014) Critical care management of intracerebral hemorrhage. Crit Care Clin 30:699-717
McMullan, Jason T; Jones, Elizabeth; Barnhart, Bruce et al. (2014) Degradation of benzodiazepines after 120 days of EMS deployment. Prehosp Emerg Care 18:368-74
McMullan, Jason T; Pinnawin, Ashley; Jones, Elizabeth et al. (2013) The 60-day temperature-dependent degradation of midazolam and Lorazepam in the prehospital environment. Prehosp Emerg Care 17:1-7
Ginsberg, Myron D; Palesch, Yuko Y; Hill, Michael D et al. (2013) High-dose albumin treatment for acute ischaemic stroke (ALIAS) Part 2: a randomised, double-blind, phase 3, placebo-controlled trial. Lancet Neurol 12:1049-58
Nakagawa, Kazuma; Vento, Megan A; Seto, Todd B et al. (2013) Sex differences in the use of early do-not-resuscitate orders after intracerebral hemorrhage. Stroke 44:3229-31
Hemphill, J Claude (2013) It's getting better all the time? Using secular trends to understand the impact of neurocritical care. Intensive Care Med 39:1489-91
Silbergleit, Robert; Durkalski, Valerie; Lowenstein, Daniel et al. (2012) Intramuscular versus intravenous therapy for prehospital status epilepticus. N Engl J Med 366:591-600
Hemphill, J Claude; Andrews, Peter; De Georgia, Michael et al. (2011) Multimodal monitoring and neurocritical care bioinformatics. Nat Rev Neurol 7:451-60
Nakagawa, Kazuma; Hills, Nancy K; Kamel, Hooman et al. (2011) The effect of decompressive hemicraniectomy on brain temperature after severe brain injury. Neurocrit Care 15:101-6

Showing the most recent 10 out of 17 publications