Improving Neonatal Transition For Compromised Infants And Minimising Lung Injury
Funder
National Health and Medical Research Council
Funding Amount
$188,226.00
Summary
The projects in this proposal are designed to improve the health of newly born infants before they are born (fetal lactate blood test to assist in decision making), at birth (randomized clinical trials to provide evidence for future resuscitation guidelines) and in the first few hours following preterm birth by studying alternative methods of providing existing therapies for neonatal respiratory distress syndrome. These studies may prevent harm and allow a “Healthy start to life”.
Improving Respiratory Transition And Outcomes Of Newborn Infants
Funder
National Health and Medical Research Council
Funding Amount
$262,251.00
Summary
Effective mask ventilation is the most important intervention at birth that can reduce mortality and disability in term and preterm infants. I will develop strategies to help clinicians improve their resuscitation skills. I will also study new ways to better support babies’ transition after birth, to improve their short and long term outcomes. The results of this research will change the way newly born babies are cared for around the world.
Targeted Therapeutic Mild Hypercapnia After Resuscitated Cardiac Arrest: A Phase III Multi-Centre Randomised Controlled Trial (The TAME Cardiac Arrest Trial)
Funder
National Health and Medical Research Council
Funding Amount
$2,069,878.00
Summary
The TAME Cardiac Arrest trial will study the ability of higher carbon dioxide (CO2) levels to reduce brain damage, comparing giving patients ‘normal’ to ‘slightly higher than normal’ blood CO2 levels and assessing their ability to return to normal life-tasks. It will be the largest trial ever conducted in heart attack patients in the ICU. This therapy is cost free and, if shown to be effective, will improve thousands of Australian lives, transform clinical practice, and yield major savings.
Generating And Applying Clinical Research To Improve The Outcomes Of Neonatal Intensive Care
Funder
National Health and Medical Research Council
Funding Amount
$568,892.00
Summary
Birth is a complex process and sometimes babies require help to make the transition to independent life. Professor Peter Davis is conducting research into how best to support this transition. This involves helping the lungs to work efficiently and supporting the changes in circulation of the blood to the brain and to the rest of the body. His work aims to quickly identify babies who need help and then provide better treatments to make sure they have the best chance of a healthy life.
Optimising Lung Protective Ventilation At Birth Using The Volumetric Response Of The Lung In A Preterm Lamb Model
Funder
National Health and Medical Research Council
Funding Amount
$611,021.00
Summary
Prematurity is a common problem which constitutes a major health-care burden. The preterm lung often cannot function independently at birth but is very fragile and susceptible to damage from the very first breathes of life. Life-saving mechanical ventilatory support must protect the lung from injury as well aid lung function. This project aims to improve ventilation strategies for supporting and protecting the preterm lung using novel approaches and innovative technologies.
Novel Strategies For Improving Respiratory Support And Outcomes For Very Preterm Babies
Funder
National Health and Medical Research Council
Funding Amount
$8,381,820.00
Summary
Very premature birth is the commonest cause of illness and death in newborn babies, making it one of the most serious and costly issues in perinatal medicine. The major problem suffered by very premature babies is lung immaturity and its associated harmful effects on brain development. Most very premature babies require resuscitation followed by ventilatory support,often for several weeks. This is extremely expensive and places an enormous financial burden on health care systems. Furthermore, it ....Very premature birth is the commonest cause of illness and death in newborn babies, making it one of the most serious and costly issues in perinatal medicine. The major problem suffered by very premature babies is lung immaturity and its associated harmful effects on brain development. Most very premature babies require resuscitation followed by ventilatory support,often for several weeks. This is extremely expensive and places an enormous financial burden on health care systems. Furthermore, it increases the risks of respiratory illnesses, including bronchopulmonary dysplasia and chronic lung disease which can impair breathing and increase susceptibility to respiratory disease such as asthma later in life. The overall aim of this program is to improve outcomes for very premature babies, including less lung injury, better respiratory health and shorter stays in hospitals. In order to reduce the health burden caused by very premature birth on the community we need to know more about how it alters the normal development of the lungs in the newborn period and into later life. In particular, we need to understand the cellular and molecular processes involved in lung development so that we can identify gene networks and developmental processes that are disrupted by severe premature birth. Such knowledge is necessary to provide a more rational, scientific basis for managing and treating the alterations in lung structure and function caused by premature birth. We also need to develop better ways of resuscitating and ventilating these infants so that lung injury is minimized.The research team is led by two neonatologists and three biomedical research scientists with a proven record of effective collaboration. This team is internationally unique in that it includes practicing neonatologists, respiratory physiologists and molecular biologists who have collaborated together productively and are regarded as world leaders in their respective fields. New talents have been brought into the team to provide expertise in pulmonary stem cell biology, the design of novel steroid drugs, and clinical follow-up. Together, this team has the potential (a) to greatly enhance the understanding of the impact of very premature birth on the developing lung, (b) to improve resuscitation and ventilation techniques, and (c) to translate the new knowledge into clinical practice to improve the outcome for prematurely born babies. Using well characterized animal models we will determine gene networks involved in fetal lung development and how these are altered by premature birth. The successful transition from fetal to postnatal life is critical for survival at birth but more information is needed. Using newborn lambs and rabbits, we will trial novel strategies for enhancing the transformation of the immaturelung into an effective gas exchange organ at birth. New data on lung aeratioRead moreRead less
Optimising Lung Protective Resuscitation Using A Newborn Premature Lamb Model
Funder
National Health and Medical Research Council
Funding Amount
$392,218.00
Summary
Premature babies are at risk of severe, and potentially long-term, lung damage. These complications can be minimised if babies are optimally resuscitated at birth. This project will use promising new imaging technologies to examine the influence of different strategies, using mechanical ventilators, to help inflate the lung at birth, and their interactions with other therapies used to enhance lung maturity. It will provide new insights into resuscitating preterm babies.
A Randomised Double Blinded Placebo Controlled Trial Of Adrenaline In Cardiac Arrest.
Funder
National Health and Medical Research Council
Funding Amount
$200,500.00
Summary
It is estimated that in excess of 30,000 Australians per year suffer a cardiac arrest, mostly occurring outside of hospital. This sudden and often unpredictable event commonly occurs as a result of acute heart disease, injury, drug overdose and many other illnesses which affect both males and females of all ages. Unfortunately, the survival of those suffering a cardiac arrest remains poor. Best evidence to date suggests overall survival from cardiac arrest to be in the order of about 5%. While t ....It is estimated that in excess of 30,000 Australians per year suffer a cardiac arrest, mostly occurring outside of hospital. This sudden and often unpredictable event commonly occurs as a result of acute heart disease, injury, drug overdose and many other illnesses which affect both males and females of all ages. Unfortunately, the survival of those suffering a cardiac arrest remains poor. Best evidence to date suggests overall survival from cardiac arrest to be in the order of about 5%. While the survival for those suffering cardiac arrest remains poor, the rapid initiation of cardiopulmonary resuscitation (CPR) and defibrillation has been clearly shown to improve outcome. While defibrillation and CPR have been shown to be beneficial, the use of vasoactive drugs such adrenaline has not been proven to improve survival in cardiac arrest. This is despite adrenaline being internationally recommended as first line drug therapy in the advanced life support (ALS) management of cardiac arrest. It is now well acknowledged that clinical trials need to be undertaken to determine the clinical effects of adrenaline when used for cardiac arrest. The purpose of this study is to randomise patients suffering a cardiac arrest to receive either adrenaline (according to standard ALS guidelines) or a placebo. All other care for both groups will be the same and in accordance with current ALS guidelines. In this way we will be able to determine the effects of adrenaline on outcome, particularly survival, following cardiac arrest. The study will run for three years and involve all cardiac arrests attended by the Ambulance Service in Perth.Read moreRead less
I will determine the efficacy and safety of crystalloid resuscitation fluids in conventional models of care. This is a fundamental and unresolved question in Intensive Care Medicine and will have an impact on clinical practice worldwide. I will also consolidate and enhance a series of projects to provide the next generation of clinician-researchers with high-quality research opportunities. These include projects in sepsis, traumatic brain injury, and endocrine function in critical illness.
Up to 80% of out of hospital cardiac arrest patients do not receive bystander CPR –often because those at the scene do not have the required skills. Without immediate action the condition is fatal. Through my doctoral research I aim to investigate the best methods for providing a targeted approach of training basic life support to a group at high risk of these events -cardiac patients. I plan to develop and test the feasibility of incorporating this training into cardiac rehabilitation programs.