# Impact of Autonomic Dysfunction on Multi-Organ Dysfunction following Severe TBI: The AUTO-BOOST Study

> **NIH NIH R01** · DUKE UNIVERSITY · 2024 · $591,775

## Abstract

PROJECT SUMMARY/ABSTRACT
Traumatic brain injury (TBI) is a major public health concern, affecting more than 1.5 million individuals annually
in the United States. Extracranial multi-organ dysfunction (MODS) occurs in approximately 60% of severe TBI
patients and contributes to secondary brain injuries, increased risk for mortality, and poor functional outcomes
over the year following TBI. Our prior research has demonstrated that the prevalence of early autonomic nervous
system dysfunction is high following severe TBI and associated with cerebral metabolic crisis and MODS
development. Although treatments for autonomic dysfunction following severe TBI are readily available, a
complete characterization of the course of autonomic dysfunction following severe TBI that would be adequate
to guide therapy is lacking. Therefore, a comprehensive characterization of autonomic dysfunction after TBI and
an understanding of how early autonomic dysfunction contributes to episodes of cerebral metabolic crisis and
extracranial organ injury are urgently needed to guide the development of therapies to improve patient outcomes
following TBI. To address this, we propose the following specific aims using unique and granular waveform data
from the BOOST-3 (Brain Oxygen Optimization in Severe TBI Phase 3 trial, U01 NS099946) clinical trial: 1)
Determine the burden of early autonomic dysfunction and its relationship to cerebral metabolic crisis following
severe TBI, 2) Determine the relationship of early autonomic dysfunction with extracranial MODS and functional
neurologic outcomes following severe TBI, and 3) Assess the uniqueness and added value of cardiac waveform
data in predicting risk for MODS and functional neurologic outcomes following severe TBI. Successful completion
of this study will solidify our understanding of the effects of autonomic dysfunction after severe TBI, and inform
trials to determine the impact of modulating autonomic dysfunction on the development of MODS and poor
outcomes following severe TBI. Our long-term goal is to develop strategies to personalize critical care
management in order to improve clinical outcomes after severe TBI in adults.

## Key facts

- **NIH application ID:** 10844621
- **Project number:** 5R01NS130832-02
- **Recipient organization:** DUKE UNIVERSITY
- **Principal Investigator:** Vijay Krishnamoorthy
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $591,775
- **Award type:** 5
- **Project period:** 2023-06-01 → 2028-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10844621

## Citation

> US National Institutes of Health, RePORTER application 10844621, Impact of Autonomic Dysfunction on Multi-Organ Dysfunction following Severe TBI: The AUTO-BOOST Study (5R01NS130832-02). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/10844621. Licensed CC0.

---

*[NIH grants dataset](/datasets/nih-grants) · CC0 1.0*