The Generation Of High Quality Evidence In Critical Care Medicine Through Multicentre Randomized Controleld Trials And Its Translation Into Practice
Funder
National Health and Medical Research Council
Funding Amount
$240,121.00
Summary
This research program will establish new approaches to sepsis, traumatic brain injury, kidney protection, transfusion, post-operative care, sedation, antibiotics and mobilization of acutely ill patients. Experimental research will help understand why the kidney malfunctions during severe infection. Database investigations will identify of successful patterns of treatment and potential new fields of investigations. Informatics based studies will use electronic data to develop decision support sys ....This research program will establish new approaches to sepsis, traumatic brain injury, kidney protection, transfusion, post-operative care, sedation, antibiotics and mobilization of acutely ill patients. Experimental research will help understand why the kidney malfunctions during severe infection. Database investigations will identify of successful patterns of treatment and potential new fields of investigations. Informatics based studies will use electronic data to develop decision support systems to improve patient care.Read moreRead less
Individual Patient Data Meta-analysis Of Randomised Control Trials In Fluid Resuscitation
Funder
National Health and Medical Research Council
Funding Amount
$85,027.00
Summary
I am a registered nurse focused in critical care research. I have an interest in the area of fluid resuscitation. My aim is to carry out an individual patient data meta-analysis (IPDMA) on randomised controlled trials (RCTs) in fluid resuscitation. The IPDMA will consist of two of the largest critical care trials; Saline Vs Albumin fluid Evaluation (SAFE) study and the Crystalloid Vs Starch (CHEST) study, to add further evidence to the currently limited fluid resuscitation literature.
An Early Intervention To Prevent Muscle Weakness In Intensive Care
Funder
National Health and Medical Research Council
Funding Amount
$82,607.00
Summary
Patients commonly suffer from a debilitating and globally pronounced weakness post intensive care admission. The causes and ways to prevent this weakness are not fully understood. This study will investigate the benefits of early exercise involving electrical stimulation of the leg muscles during in-bed cycling and will compare changes in muscle size and strength compared to usual care. We will also examine why muscles become weak so quickly, to help target future treatments to prevent weakness.
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
A Centre For Research Excellence To Transform Outcomes Of Critically Ill Patients In ICU (CRE-ICU)
Funder
National Health and Medical Research Council
Funding Amount
$2,500,000.00
Summary
Patients who are admitted to intensive care (ICU) and require mechanical ventilation for life support account for 63,000 ICU admissions and 8,190 deaths each year in Australia, higher than the national road toll. CRE-ICU will transform outcomes for these patients by using data within registries and electronic medical records to perform high-impact, low cost clinical trials, generating new knowledge to inform national guidelines and policies and training the next generation of researchers.
Optimising Nutrient Delivery And Absorption In Critically Ill Patients
Funder
National Health and Medical Research Council
Funding Amount
$560,715.00
Summary
Patients surviving ICU are frequently discharged malnourished. Adequate nutrition is essential for optimal outcomes. It is considered best practice to administer nutrition as a liquid formula via a tube passed through the nose into the stomach, however this is frequently limited by impaired gastrointestinal function. We aim to develop more effective strategies for the provision of nutrition to improve nutritional and thereby clinical outcomes in critically ill patients.
Management Of Refeeding Syndrome In Critical Illness: An AuSPEN Endorsed Multi-centre Clinical Trial
Funder
National Health and Medical Research Council
Funding Amount
$1,366,987.00
Summary
Critically ill hospitalised patients are frequently malnourished. When feeding is reestablished in malnourished patients, they often exhibit severe electrolyte imbalances and metabolic disturbances that can lead to slower recovery times, increased complications and even death. The purpose of this clinical trial is to investigate the benefits of a conservative approach of managing critically ill patients with refeeding syndrome.
Our lives depend upon maintaining the correct body temperature. Failure to regulate it properly may be lethal. This is particularly true in the elderly, who are more susceptible on the one hand to heat stroke and on the other to hypothermia. Many die each year from both these causes. Body temperature is regulated by the brain, yet our understanding of how and where in the brain this happens is poor. This proposal aims to work out the 'wiring diagram' of brain temperature control pathways in rats ....Our lives depend upon maintaining the correct body temperature. Failure to regulate it properly may be lethal. This is particularly true in the elderly, who are more susceptible on the one hand to heat stroke and on the other to hypothermia. Many die each year from both these causes. Body temperature is regulated by the brain, yet our understanding of how and where in the brain this happens is poor. This proposal aims to work out the 'wiring diagram' of brain temperature control pathways in rats and to begin to extend this knowledge to humans. This work will generate new knowledge about a vital function. The insights obtained will inform and guide future strategies in aged care, intensive care and perioperative care.Read moreRead less
The Cost-effectiveness Of Early Resuscitation Of Sepsis In Australia - An Economic Evaluation Alongside The ARISE-RCT
Funder
National Health and Medical Research Council
Funding Amount
$115,971.00
Summary
Critical care treatment is expensive and consumes a significant portion of hospital resources. This study will collect cost, survival and quality of life data on a group of sepsis patients enrolled in a trial of strict protocolised treatment versus standard care (the ARISE study). This information will be used to determine how much it costs for each additional survivor with protocolised treatment, and how much it costs for each quality adjusted life year gained with protocolised treatment.
Sepsis is a major cause of hospitalization and ICU admission in Australia population corresponding to more than 15700 new cases each year. Every year more than 3000 people die from sepsis in Australia which is greater than the annual national road toll and breast, prostate or colorectal cancer. The research outlined in this proposal to study the effect of steroids and vitamin D to improve patient’s recovery from sepsis and also understand the genetic basis behind their ability to survive sepsis.