Ava Puccio, RN, PhD

  • Assistant Professor
  • Co-Director, Neurotrauma Clinical Trials Center

Ava M. Puccio, RN, PhD, is an assistant professor in the department of neurological surgery and also co-director of the Neurotrauma Clinical Trials Center in collaboration with David O. Okonkwo, MD, PhD.

Dr. Puccio received her bachelor of science degree in neuroscience in 1988 and bachelor degree in nursing in 1994, both from the University of Pittsburgh. In 1995, she joined the Department of Neurological Surgery as a nurse coordinator on the National Acute Brain Injury Study: Hypothermia (NABIS:H) study and also the coordinator for the Brain Trauma Research Center.

Throughout her years of employment as a nurse coordinator, she pursued part-time advanced schooling to graduate with a master’s degree in nursing from the University of Pittsburgh in 2000 and as a university scholar (top 2% of class) from the University of Pittsburgh School of Nursing with a doctoral degree, emphasis in neuroscience in 2008. Her dissertation, “Effect of short periods of normobaric hyperoxia on local brain tissue oxygenation and cerebrospinal fluid oxidative stress markers in severe traumatic brain injury” was published in the Journal of Neurotrauma in 2009.

Dr. Puccio was appointed assistant professor in the Department of Neurological Surgery at the University of Pittsburgh in 2010 and received her adjunct faculty position with The School of Nursing, Department of Acute/Tertiary Care in 2010 with collaborations with Yvette Conley, PhD and Richard Henker, RN, PhD.

Her research has focused on improving outcomes in traumatic brain injury patients, with clinical venues of controlled normothermia, mechanisms of brain oxygenations and exploring genetic variances and expression on outcome and was awarded a K99/R00 NINR grant in 2014, entitled “Transcriptomics in Traumatic Brain Injury: Relationship to Brain Oxygenation and Outcomes.”

With 23 years of clinical trial design, involvement and management, several traumatic brain and spine injury research studies have been completed and are ongoing. Many cutting-edge biomarker and high definition fiber tracking imaging and additional observational research studies are being conducted. Dr. Puccio is very involved in the Transforming Research and Clinical Knowledge in TBI (TRACK-TBI) consortium and was awarded a Department of Defense grant as PI of the Biospecimen Repository which collects, catalogues and stores cerebrospinal fluid, blood, serum DNA and RNA samples obtained from mild, moderate and severe TBI patients at 17 clinical sites. Dr. Puccio is a member of the Neurocritical Care Society, Society of Critical Care Medicine, National Neurotrauma Society and currently serves as the secretary/treasurer for the Women in Neurotrauma Research (WiNTR).

Specialized Areas of Interest

Traumatic brain injury research

Board Certifications

RN License: Pennsylvania

Hospital Privileges

UPMC Mercy
UPMC Presbyterian

Professional Organization Membership

Eastern Nursing Research Society
National Neurotrauma Society
Neurocritical Care Society
Sigma Theta Tau International Nursing Honor Society
Society of Critical Care Medicine
Women in Neurotrauma Research (WINTR)

Education & Training

  • BS, Neuroscience, University of Pittsburgh, 1988
  • BSN, Nursing, University of Pittsburgh, 1994
  • MSN, Nursing, University of Pittsburgh, 2000
  • PhD, Nursing/Neuroscience, University of Pittsburgh, 2008

Honors & Awards

  • Cold Spring Harbor Scholarship, 2012
  • Ruth Perkins Kuehn Nursing Research Award, 2011
  • Cameos of Caring Nursing Scholarship, 2007
  • Society of Critical Care Nursing Section Award, 2006

Selected Publications

Lingsma HF, Yue JK, Maas AI, Steyerberg EW, Manley GT, TRACK-TBI Investigators. Outcome prediction after mild and complicated mild traumatic brain injury: external validation of existing models and identification of new predictors using the TRACK-TBI pilot study. Journal of Neurotrauma32(2):83-94, 2015.

Chmura J, Presson N, Benso S, Puccio AM, Fissel K. A high-definition fiber tracking report for patients with traumatic brain injury and their doctors. Military medicine, 180(3 Suppl):122-34, 2015.

Presson N, Krishnaswamy D, Wagener L, Bird W, Jarbo K, Pathak S, Puccio AM, Benso S, Okonkwo DO, Schneider W. Quantifying white matter structural integrity with high-definition fiber tracking in traumatic brain injury. Military Medicine 180(3 Suppl):109-21, 2015.

McMahon PJ, Panczykowski DM, Yue JK, Puccio AM, Inoue T. Measurement of the glial fibrillary acidic protein and its breakdown products GFAP-BDP biomarker for the detection of traumatic brain injury compared to computed tomography and magnetic resonance imaging. Journal of Neurotrauma 32(8):527-33, 2015.

Salibi PN, Agarwal V, Panczykowski DM, Puccio AM, Sheetz MA. Lifetime attributable risk of cancer from CT among patients surviving severe traumatic brain injury. American Journal of Roentgenology 202(2):397-400, 2014.

Yuh EL, Cooper SR, Mukherjee P, Yue JK, Lingsma HF, TRACK-TBI Investigators. Diffusion tensor imaging for outcome prediction in mild traumatic brain injury: a TRACK-TBI study. Journal of Neurotrauma 31(17):1457-77, 2014.

Wright DW, Yeatts SD, Silbergleit R, Palesch YY, Hertzberg VS, NETT Investigators. Very early administration of progesterone for acute traumatic brain injury. The New England Journal of Medicine 371(26):2457-66, 2014.

Diaz-Arrastia R, Wang KK, Papa L, Sorani MD, Yue JK, Puccio AM, McMahon PJ, Inoue T, Yuh EL, Lingsma HF, Maas AI, Valadka AB, Okonkwo DO, Manley GT; Track-TBI Investigators, Casey IS, Cheong M, Cooper SR, Dams-O'Connor K, Gordon WA, Hricik AJ, Menon DK, Mukherjee P, Schnyer DM, Sinha TK, Vassar MJ. Acute biomarkers of traumatic brain injury: relationship between plasma levels of ubiquitin C-terminal hydrolase-L1 and glial fibrillary acidic protein. J Neurotrauma 31(1):19-25, 2014.

Conley YP, Okonkwo DO, Deslouches S, Alexander S, Puccio AM, Beers SR, Ren D. Mitochondrial polymorphisms impact outcomes after severe traumatic brain injury. J Neurotrauma 31(1):34-41, 2014.

Nwachuku EL, Puccio AM, Fetzick A, Scruggs B, Chang YF, Shutter LA, Okonkwo DO. Intermittent versus continuous cerebrospinal fluid drainage management in adult severe traumatic brain injury: Assessment of intracranial pressure burden. Neurocritical Care 20(1):49-53, 2013. 

A complete list of Dr. Puccio's publications can be reviewed through the National Library of Medicine's publication database.

Research Activities

The ultimate goal of Dr. Puccio’s career trajectory is to research innovative treatment paradigms for individualized care of TBI patients, with an emphasis on the secondary injury mechanisms following TBI. Mechanisms include temperature management, brain oxygenation optimization and genetic influences including variations and genomic (for example hypoxic signaling). 

Recent clinical trials of pharmacotherapy in TBI patients have not shown efficacy, including a Phase 3 study of a neuroprotective agent, progesterone, SyNAPSE trial in patients with severe TBI (GCS 3-8) (Principal Investigator: David O. Okonkwo, MD, PhD). TBI heterogeneity has been indicated as a cause for failure of these trials; however, we are exploring other means to design more effective clinical trials. A recent collaborative clinical trial that is in the start-up phase includes Brain Oxygen Optimization in Severe Traumatic Brain Injury—Phase 3 (BOOST-3); (PI: Lori Shutter, MD; David O. Okonkwo, MD, PhD).

Additional clinical studies include the prospective collection of demographics, blood and cerebrospinal fluid and neurological outcomes for the Neurotrauma Clinical Trials Center in Pittsburgh, (PI: David O. Okonkwo, MD, PhD; co-PI: Ava M. Puccio, RN, PhD); saliva-based biomarkers (PI: Ava M. Puccio, RN, PhD) and genetic repositories (severe TBI, PI: Yvette Conley, PhD; moderate/mild TBI co-PI: David O. Okonkwo, MD, PhD). Collaborative external research with the University of Cincinnati (PI: Jed Hartings, PhD) examining the impact of brain seizure-like activity (spreading depressions) on recovery from TBI, and with the University of California, San Francisco (PI: Geoff Manley, MD, PhD) examining and refining a standard for data collection in TBI studies, suitable for use across the broad spectrum of TBI and to explore novel approaches for classification of the initial injury severity and outcome after TBI, making use of emerging technology. Collaborative translational research with industry to validate a commercial handheld hematoma detector for detection of an intracranial blood clot in the acute setting (PI: Ava M. Puccio, RN, PhD) and an upcoming blood-based biomarker study examining a point-of-care device with Abbott Laboratories
(PI: David O. Okonkwo, MD, PhD).

Media Appearances