AG Bösel: Critical Care of Stroke
Welcome to the Heidelberg neurocritical care research group.
Our group is dedicated to the analysis and better understanding of critical care aspects of cerebrovascular disease. The aim is to improve the critical care management of patients with severe ischemic and hemorrhagic stroke. The projects and studies are entirely clinical or have strong relations to real-life clinical situations. The designs of the projects comprise the full spectrum from performing retrospective monocentric analyses to leading coordination of randomized multicenter trials. Although all projects are currently vascular, we are also open for research in other areas of neurocritical care.
Dr. Julian Bösel is certified neurologist and holds additional certifications in neurological intensive care and neurological laboratory medicine. He directs the neurological intensive care unit as the leading attending, leads this research group and coordinates all NICU-research projects, of most of which he is the principal investigator. His own fields of interest are space-occupying ischemic infarctions, airway management (in-/extubation, tracheostomy), analgosedation, as well as management and monitoring of oxygenation in patients with severe strokes. In terms of multicenter trials, he is the national leading coordinator of TALECRIS (intra-arterial plasmin in acute brain vessel occlusion), vice-coordinator and regional principal investigator of DESTINYII (hemicraniectomy in malignant MCA-infarction of patients > 60 years), regional principal investigator of DEPTH-SOS (hemicraniectomy and hypothermia in malignant MCA-infarction) and will launch the up-coming SETPOINT2 (early tracheostomy in ventilated stroke patients) as the leading coordinator. He encourages national and international research cooperation and is an active member of the DGNI and its research network IGNITE, the DIVI and the NCS.
In the following, the researchers of the group will be shortly introduced and their projects outlined. If not otherwise stated, all members of the group are also clinical doctors of the Heidelberg Department of Neurology. For more details on the respective studies do not hesitate to contact them via the given email addresses. In case of interest on cooperation in new or currently ongoing trials of the group, please contact julian.boesel(at)med.uni-heidelberg.de.
Logistics of studies / tracheostomy
Dr. Silvia Schönenberger supervises the Heidelberg NICU as the resident in-chief and coordinates the logistics of many research projects. In addition, she is involved in the pilot trial SETPOINT (early tracheostomy in ventilated stroke patients) and will be local sub-investigator of the multicenter follow-up trial SETPOINT2.
Decompressive surgery in malignant MCA-infarction
Dr. Hemasse Amiri is sub-investigator of the DESTINYII trial (Decompressive surgery in malignant MCA-infarction in patients > 60 years) and does important coordinative work in the Heidelberg trial team which is the leading study center. Additionally, she is the regional principal investigator of the DESTINY-Registry.
Volatile Anesthetics in cerebrovascular neurocritical care patients
Dr. Jan Purrucker is sub-investigator of the VANISH projects (volatile anesthetics for sedation in ischemic stroke and hemorrhage, employing isoflurane and sevoflurane via the AnaConDa™ system) the safety studies of which are almost finished. He will be centrally involved in the up-coming specific trials in this field.
Analgosedation in cerebrovascular neurocritcal care
Dr. Faisal Ben-Swuaidan ist Gastarzt aus Riad, Saudi-Arabien, Facharzt für Neurologie und Intensivmedizin, der auf unserer Station die prospektiven Projekte PRINCIPLE (Prädiktoren für den (Miss-)Erfolg geplanter Extubationen), SETScore (Prädiktionsscore für Tracheotomiebedarf) und ASCETIC (Vergleich von Analgosedierungsverfahren) betreut. Ein Teil der Projekte wird nach seiner Rückkehr nach Riad bizentrisch fortgeführt werden.
Cardiac complications in zerebrovascular neurocritcal care
Dr. Mehrdad Sheikvatan, a cardiologist from Tehran, Iran, is a guest-doctor at our unit who is conducting the ACCOMPLISH study (Arrhythmias and other cardiac complications in NICU stroke and their implications) and is involved in other projects of the group as an experienced statistician.
Mortality and morbidity in neurocritical care
Dr. Igor Milet is intensivist and guest-doctor from Porto, Portugal. His research focus is on resuscitation, sepsis and morbidity/mortality epidemiology in intensive care. He has performed a semi-prospective analysis of morbidity and mortality on our NICU employinh established indices thereof.
Anemia after severe ischemic stroke
Dr. Lars Kellert conducts the STRAIGHT projects (Impact of hemoglobin, hematocrit and transfusion after ischmic stroke). After two retrospective analyses in thrombolysed stroke patients, he is currently working on a semi-prospective analysis of NICU-stroke patients who received different transfusion regimes.
The aim is a prospective transfusion trial to clarify optimal hematological management of severe stroke.
Complications of decompressive surgery for space-occupying ischemic stroke
Dr. Zhongying Peng retrospectively analyses complications of decompressive surgery for space-occupying infarctions in the anterior and posterior circulation.
Additionally, she is one of sub-investigators of SETPOINT (Early tracheostomy in ventilated stroke patients).
Cooperations with research groups:
Research Group - Multimodales Neuromonitoring / Autonomic Dysfunction
Dr. Jennifer Diedler focuses on continuous extended multimodal neuromonitoring including ICP, PtO2, microdialysis, electrocorticography, EEG, NIRS and continuous AEP-monitoring. Focus of her studies is cerebral autoregulation and optimized CPP management in stroke patients.
Dr. Marek Sykora, PhD focuses on autonomous dysfunction and its associations with secondary brain injury in the course of cerebrovascular disease and interactions between cerebral autoregulation and autonomic nervous system.
AG HYPOthermia 24/7 - Temperature Management in Cerebrovascular Disease
Dr. Sven Poli, research topic is the clinical evaluation of pleotropic neuroprotection via normothermia and hyperoxygenation in cardiovascular disease.