Improving Ubiquitous Interventions To Optimise Outcomes From Critical Illness
Funder
National Health and Medical Research Council
Funding Amount
$333,710.00
Summary
A/Prof Deane is a specialist intensive care physician who combines clinical work at The Royal Melbourne Hospital with a large research program. The research supported by this Fellowship will translate to fundamental changes in the administration of ubiquitous interventions and will optimise management of conditions that occur frequently in the critically ill and represent a major source of mortality, morbidity and healthcare utilisation/costs.
Causes And Management Of Abnormally Elevated Blood Glucose Concentrations In The Critically Ill
Funder
National Health and Medical Research Council
Funding Amount
$430,770.00
Summary
Increased glucose concentrations occur commonly in ICU patients and are associated with increased mortality and morbidity. There is a need to improve the understanding of the causes underlying so-called 'critical illness induced hyperglycaemia' as well as new therapies to reduce blood glucose in this group. The proposed studies will focus on the potential role of incretin hormones, which have the capacity to stimulate insulin without increasing the risk of abnormally low blood glucose levels.
Determining The Affect And Cost Effectiveness Of Nutrition In Critically Ill Patients From Intensive Care Unit Admission To Hospital Discharge.
Funder
National Health and Medical Research Council
Funding Amount
$138,964.00
Summary
Nutrition when you are severely unwell is very important to support recovery. Research is required to determine exactly how much nutrition is needed in severely ill patients to ensure their best recovery. This project aims to determine what effect nutrition has on clinical and functional outcomes of patients who are severely ill during their whole hospital stay. It will also aim to determine the cost effectiveness of nutrition for these patients.
Early Parenteral Nutrition Vs. Standard Care In The Critically Ill Patient: A Level I Randomised Controlled Trial.
Funder
National Health and Medical Research Council
Funding Amount
$1,852,333.00
Summary
Nutritional support is accepted as a standard of care for the hospitalised patient however there is little agreement as to how it should be provided to the critically ill patient. Despite the fact that studies consistently link malnutrition to worse outcomes, the provision of nutritional support to the critically ill patient is highly variable. Although there is general agreement that it is best to feed critically ill patients via the gastrointestinal tract (stomach tube feeding), there is no ge ....Nutritional support is accepted as a standard of care for the hospitalised patient however there is little agreement as to how it should be provided to the critically ill patient. Despite the fact that studies consistently link malnutrition to worse outcomes, the provision of nutritional support to the critically ill patient is highly variable. Although there is general agreement that it is best to feed critically ill patients via the gastrointestinal tract (stomach tube feeding), there is no general agreement as to when intravenous artificial nutrition should be begun if a patient cannot tolerate a feeding tube. A recent systematic review of all available clinical trials suggests that if a critically ill patient cannot be fed by a stomach tube for at least 24 hours, they may benefit from intravenous artificial nutrition. This is not what currently happens under standard care. The purpose of this multi-centre randomised controlled trial is to determine if early intravenous nutrition saves lives. Because of the cost, and possible risk of increased infections, a study of this type is required before early intravenous nutrition could become a routine therapy in Australia. Informed consent to participate in the study will be obtained from next of kin, or directly from the patient themselves. The study will be managed at the Royal North Shore Hospital, University of Sydney and will include 26 collaborating ANZ hospitals over 18 months.Read moreRead less
Centre Of Clinical Research Excellence In Nutritional Physiology, Interventions, And Outcomes
Funder
National Health and Medical Research Council
Funding Amount
$2,007,200.00
Summary
Over 20% of Australian adults either have diabetes, or are at imminent risk, while 60% are overweight or obese. Conversely, some 40% of the elderly receiving domiciliary support are at risk of malnutrition. Poor nutrition underpins numerous chronic diseases. We seek to capitalise on the expertise and multidisciplinary collaborations of several groups, all leaders in their fields, and whose collective track record in clinical nutrition research cannot be matched in Australia, to form a Centre of ....Over 20% of Australian adults either have diabetes, or are at imminent risk, while 60% are overweight or obese. Conversely, some 40% of the elderly receiving domiciliary support are at risk of malnutrition. Poor nutrition underpins numerous chronic diseases. We seek to capitalise on the expertise and multidisciplinary collaborations of several groups, all leaders in their fields, and whose collective track record in clinical nutrition research cannot be matched in Australia, to form a Centre of Excellence that encompasses the physiology of nutrition, dietary intervention strategies, and evaluation of outcomes, in diabetic, overweight, elderly, and critically unwell populations.Read moreRead less
Upper Gastrointestinal Motor And Absorptive Function In Critically Ill Patients
Funder
National Health and Medical Research Council
Funding Amount
$260,760.00
Summary
A major concern in critically ill patients is the provision of adequate nutrition to facilitate recovery from devastating metabolic insults. Abnormal contractions of the oesophagus, stomach and small intestine appear to be common in critically ill patients. These may prevent effective feeding of patients at a time when they are especially vulnerable to malnutrition and also result in major complications such as pneumonia, septicaemia and gastrointestinal haemorrhage. However little is known abou ....A major concern in critically ill patients is the provision of adequate nutrition to facilitate recovery from devastating metabolic insults. Abnormal contractions of the oesophagus, stomach and small intestine appear to be common in critically ill patients. These may prevent effective feeding of patients at a time when they are especially vulnerable to malnutrition and also result in major complications such as pneumonia, septicaemia and gastrointestinal haemorrhage. However little is known about the reasons underlying these dysfunctions. The applicants, with ongoing support from the NH and MRC have had a longstanding interest in motility disorders of the gut and have made important contributions to knowledge about both the causes and treatments of these conditions. These contributions have been underpinned by pioneering the development of new methodologies to examine gut function. In collaboration with the intensive care specialists in Adelaide, we now seek to apply this knowledge to evaluate gut function in patients in the Intensive Care Unit. The proposed studies will provide the most comprehensive studies to date of the gut function in critically ill patients and have important implications for treatment.Read moreRead less
Oesophageal, Gastric And Small Intestinal Motility In Critical Illness
Funder
National Health and Medical Research Council
Funding Amount
$494,250.00
Summary
A major concern in critically ill patients is the provision of adequate nutrition to facilitate recovery from devastating insults. Abnormal contractions of the oesophagus, stomach and small intestine occur commonly in critically ill patients. These may prevent effective feeding of patients at a time when they are especially vulnerable to malnutrition and also result in major complications such as pneumonia, septicaemia and gastrointestinal haemorrhage. The applicants, with the support of the NH ....A major concern in critically ill patients is the provision of adequate nutrition to facilitate recovery from devastating insults. Abnormal contractions of the oesophagus, stomach and small intestine occur commonly in critically ill patients. These may prevent effective feeding of patients at a time when they are especially vulnerable to malnutrition and also result in major complications such as pneumonia, septicaemia and gastrointestinal haemorrhage. The applicants, with the support of the NH and MRC, have had a longstanding interest in motility disorders of the gut and have made important contributions to knowledge about both the causes and treatments of the disturbances that occur in the oesophaus, stomach and small intestine. In the previous grant (207753) these studies have provided the most comprehensive studies to date of the motor abnormalities associated with gut dysfunction in critical illness which have important implications for treatment. The applicants now seek to continue their work by investigating the mechanisms underlying these motor abnormalities and the impact of therapeutic strategies designed to enhance delivery of nutrition to critically ill patients.Read moreRead less
Towards Evidence-based Care For Rett Syndrome: A Research Model To Inform Management Of Rare Disorders
Funder
National Health and Medical Research Council
Funding Amount
$458,046.00
Summary
Rett syndrome is a rare but serious genetic neurological disorder affecting mainly girls and often complicated by spinal curvature and poor growth. This project will use national register data collected over 16 years to examine change in functional abilities and progression of the scoliosis curve. It will develop guidelines and improve processes to assist with diagnosis and will comprehensively evaluate the surgical treatments used in the management of scoliosis and growth problems.