The main focus of my research is to improve outcomes following frostbite injury. I have been PI on a prospective-observational study of frostbite outcomes at our high-volume center for over 10 years. This has resulted in numerous novel publications assessing factors that impact frostbite outcomes. My work in this field has led me to be an invited session lead for the frostbite session at the American Burn Association State of the Science Conference and a lead for the clinical practice guidelines group of the American Burn Association for the treatment and management of frostbite injury.
Frostbite Research
Frostbite can result in debilitating injuries leading to life-long disabilities. Minnesota has a harsh winter climate with temperatures frequently dropping below -20 F and with wind chills it can be below -50 F. Our frostbite studies at Hennepin Healthcare have resulted in numerous publications and presentations nationally and regionally.
Want to use the Hennepin Frostbite Score in your research? Link to PDF
Ongoing and recently completed projects I would like to highlight
1. Nygaard RM. Frostbite in January - Amputate in July: Do non-high volume centers practice watchful waiting for surgical management following frostbite injury? World Trauma Congress. Tokyo, Japan 2023
2. Coward A, Dahl R, Freese R, Schmitz K, Endorf FW, Lumbard D, Nygaard RM. Eye of the Beholder: Does Visual Assessment in Severe Frostbite Accurately Predict Need for Thrombolytics? Podium presentation. ABA 2023 meeting.
3. Frostbite: Current Controversies and Cares. 2023 American Burn Association Meeting Course Director
4. Nygaard RM. Frostbite Management: Moving Forward at a Glacial Pace but Time Matters for Best Outcomes. Midwestern Burn Conference. Invited Speaker. October 2022
5. American Burn Association Frostbite Clinical Practice Guidelines Committee Co-Lead
6. Frostbite State of the Science – American Burn Association Co-Lead
7. Total Burn Care, 6th edition. Frostbite chapter Co-Author
Wibbenmeyer L, Lacey AM, Endorf FW, Logsetty S, Wagner ALL, Gibson ALF, Nygaard RM. American Burn Association Clinical Practice Guidelines on the Treatment of Severe Frostbite. Journal of Burn Care and Research. In Press.
Murphy J, Endorf FW, Winters MK, Rogers C, Walter E, Neumann N, Weber L, Lacey AM, Punjabi G, Nygaard RM. Bleeding Complications in Patients with Severe Frostbite Injury. Journal of Burn Care and Research. J Burn Care Res. 2022 Dec 9:irac180. doi: 10.1093/jbcr/irac180. Epub ahead of print. PMID: 36482743.
Raleigh SM, Samson M, Nygaard R, Endorf F, Walter J, Masters T. Bedside Fluorescence Microangiography for Frostbite Diagnosis in the Emergency Department. West J Emerg Med. 2022 Oct 23;23(6):872-877. doi: 10.5811/westjem.2022.8.55020. PMID: 36409932; PMCID: PMC9683761.
Coward A, Endorf FW, Nygaard RM. Revision Surgery Following Severe Frostbite Injury Compared to Similar Hand and Foot Burns. Journal of Burn Care and Research. 2022 Jun 21. Online ahead of print. PMID:35986492.
Endorf FW, Alapati D, Xiong Y, DiGiandomenico C, Rasimas CS, Rasimas JJ, Nygaard RM. Biopsychosocial Factors Associated with Complications in Patients with Frostbite. Medicine (Baltimore). 2022 Aug 26;101(34):e30211. PMID: 36042625
Rogers C, Endorf FW, Schmitz K, Fey R, Gayken J, Nygaard RM. The effects of rapid rewarming on tissue salvage in severe frostbite injury. Journal of Burn Care and Research. 2021 Nov 16. PMID: 34791315.
Endorf FW, Nygaard RM. Socioeconomic and comorbid factors associated with frostbite injury in the United States. J Burn Care Res. 2021 Aug 25:irab162. doi: 10.1093/jbcr/irab162. Epub ahead of print. PMID: 34432022.
Endorf FW, Nygaard RM. Social determinants of poor outcomes following frostbite injury: a study of the National Inpatient Sample. J Burn Care Res. 2021 Jun 17:irab115. doi: 10.1093/jbcr/irab115. Epub ahead of print. PMID: 34139760.
Endorf FW, Nygaard RM. High Cost and Resource Utilization of Frostbite Readmissions in the United States. J Burn Care Res. 2021 May 16:irab076. doi: 10.1093/jbcr/irab076. Epub ahead of print. PMID: 33993288.
Lacey AM, Rogers C, Endorf FW, Gayken JR, Schmitz KR, Punjabi GV, Whitley AB, Masters TC, Moore JC, Fey R, Nygaard RM. The Hennepin Protocol – Retrospective analysis of an institutional treatment algorithm for severe frostbite. Journal of Burn Care and Research. 2021 Jan 23. PMID: 33484248. doi: 10.1093/jbcr/irab008
Lumbard DC, Lacey AM, Endorf FW, Gayken JR, Fey RM, Schmitz KR, Deisler RF, Calcaterra D, Prekker M, Nygaard RM. Severe hypothermia and frostbite requiring ECMO and four limb amputations. J Burn Care Res. 2020. PMID: 32663261 doi: 10.1093/jbcr/iraa113.
Lacey AM, Fey RM, Gayken JR, Endorf FW, Schmitz KR, Punjabi GV, Masters TC, Nygaard RM. Microangiography: An alternative tool for assessing severe frostbite injury. Journal of Burn Care and Research. 2019; Aug 14, 40(5):566-569. PMID: 31298700. doi: 10.1093/jbcr/irz112.
Nygaard RM, Endorf FW. Frostbite Versus Burns: Increased Cost of Care and Use of Hospital Resources. Journal of Burn Care and Research. 2018; 39(5): 676-79. PMID: 29917086. doi: 10.1093/jbcr/iry033
Nygaard RM and Endorf FW. Frostbite in the United States: An Examination of the National Burn Repository and National Trauma Data Bank. J Burn Care Res. 2018 Aug 17;39(5):780-5. PMID: 29931369. doi: 10.1093/jbcr/irx048
Nygaard RM, Lacey AM, Lemere A, Dole M, Gayken JR, Lambert Wagner AL, Fey RM. Time Matters in Severe Frostbite: Assessment of Limb/Digit Salvage on the Individual Patient Level. J Burn Care Res. 2017;38(1):53-9. PMID:27606554. DOI: 10.1097/BCR.0000000000000426
Dole M, Endorf FW, Gayken J, Fey R, Nygaard RM. Early mobilization in lower extremity frostbite injury: preliminary experience at a single burn center. J Burn Care Res. 2018 April 20;39(3):339-44. PMID: 28570307. doi: 10.1097/BCR.0000000000000590
Masters T, Omodt S, Gayken J, Logue C, Westgard B, Hendricksen S, Walter J, Nygaard R. Microangiography to monitor treatment outcomes following severe frostbite injury to the hands. J Burn Care Res. 2018; 39(1):162-7. PMID: 28328661. doi: 10.1097/BCR.0000000000000526
Nygaard RM, Whitley AB, Fey RM, Wagner AL. The Hennepin Score: Quantification of Frostbite Management Efficacy. J Burn Care Res. 2016;37(4):E317-22). PMID: 26536540. DOI: 10.1097/BCR.0000000000000277