# Neuroprotection following cardiac arrest: A Randomized Control Trial of Magnesium

> **NIH NIH R34** · NEW YORK UNIVERSITY SCHOOL OF MEDICINE · 2024 · $254,250

## Abstract

Project Summary/Abstract
Cardiac arrest has an estimated annual incidence of 250-350,000 out-of-hospital and 250-750,000 in-hospital
events in the U.S., with survival rates as low as 5% and 20% respectively. These outcomes reflect a two-step
injury process: a) ischemia during cessation of blood flow and b) secondary reperfusion and inflammatory injury
following return of spontaneous circulation (ROSC). With only 3-7% of CA survivors recovering to their pre-CA
neurological status, developing interventions to attenuate reperfusion injury are critical to improve patients’
survival and neurological outcomes. A series of animal and human studies have shown that the use of
pharmacological interventions targeted against excitoxicity, oxidative injury and inflammatory pathways may
reduce ischemia/reperfusion injury and improve post-CA survival and neurological outcomes. A small-scale
randomized control trial (RCT) has provided preliminary evidence to support the hypothesis that magnesium
(Mg) in the post-CA period as a neuroprotective agent may improve neurological outcomes among survivors.
However, additional data is needed to support its use as standard of care in the post-CA period. We therefore
propose to collect necessary and sufficient data to design a multisite RCT of Mg neuroprotection following CA.
We hypothesize that administering Mg in the post-CA period is feasible and safe, and that it may attenuate
excitotoxity, thereby ameliorating the downstream cascade of reperfusion injuries associated with morbidity and
mortality. The current application proposes three aims: For Aim 1, a single site pilot RCT will assess the feasibility
and safety of administrating Mg and collecting serum samples post-CA. The effects of Mg on serum markers of
brain injury, inflammation, and oxidative stress, as well as, rates of ROSC, survival and independent neurological
function will also be assessed. For Aim 2, researchers will establish single-IRB (S-IRB) approval for a multi-site
pilot RCT of Mg post-CA using Exception From Informed Consent (EFIC). Eligible sites will then be invited to
participate in a pilot study. For Aim 3, sites identified in Aim 2 will demonstrate capacity for recruitment and data
collection by administering the Mg therapy in up to 4 and placebo in up to 4 post-CA patients. The data obtained
through the execution of Aims 1-3 will be used to inform the design and implementation of a large-scale trial to
assess the impact of Mg (with standard post-CA care) versus placebo (with standard post-CA care) on survival
and independent neurological function after CA.

## Key facts

- **NIH application ID:** 10914294
- **Project number:** 5R34HL166859-02
- **Recipient organization:** NEW YORK UNIVERSITY SCHOOL OF MEDICINE
- **Principal Investigator:** Sam Parnia
- **Activity code:** R34 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $254,250
- **Award type:** 5
- **Project period:** 2023-09-01 → 2026-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10914294

## Citation

> US National Institutes of Health, RePORTER application 10914294, Neuroprotection following cardiac arrest: A Randomized Control Trial of Magnesium (5R34HL166859-02). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10914294. Licensed CC0.

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