A Randomised Trial Of Core Cooling Versus Surface Cooling In Comatose Survivors Of Prehospital Cardiac Arrest
Funder
National Health and Medical Research Council
Funding Amount
$309,000.00
Summary
Pre-hospital sudden cardiac arrest (SCA) is a major public health problem that is estimated to cause around one death per thousand adults per year. The aetiology of SCA is usually ischaemic heart disease causing ventricular fibrillation (VF). The current medical response to this condition involves a Chain of Survival, including early call to 000, bystander CPR, early defibrillation and early advanced cardiac life support. Following successful cardiac resuscitation, patients are transported to ho ....Pre-hospital sudden cardiac arrest (SCA) is a major public health problem that is estimated to cause around one death per thousand adults per year. The aetiology of SCA is usually ischaemic heart disease causing ventricular fibrillation (VF). The current medical response to this condition involves a Chain of Survival, including early call to 000, bystander CPR, early defibrillation and early advanced cardiac life support. Following successful cardiac resuscitation, patients are transported to hospital for further care. Despite this approach and recent improvements such as decreased ambulance response times, outcome remains poor and there are very few survivors who make a good recovery. This proposal is for funding to conduct a randomised, controlled trial, which compares two different techniques of induction of hypothermia in patients who are resuscitated from pre-hospital sudden cardiac arrest. Recently available data suggests that the outcome from SCA is significantly improved if moderate hypothermia is used as a treatment of neurological injury. However, the technique of induction of hypothermia requires further research. This study compares core-cooling using large-volume ice-cold intravenous fluid with the current technique of using ice packs for surface cooling, initiated in the field by ambulance paramedics and continued in hospital for a total of 12 hours. This study has the potential to demonstrate a significant improvement in outcome in a common clinical condition, which currently carries a very high mortality rate. This will be the first trial internationally which assess core versus surface cooling initiated pre-hospital, in SCA patients. It is highly likely that with the successful results from this trial that induced hypothermia in SCA patients will become standard care. The use of induced hypothermia could lead to over 500 lives saved per year accross Australia.Read moreRead less
Imaging And Chemical Biomarkers For Assessing The Effectiveness Of Therapy In The First European Investigator-driven Clinical Trial Investigating The Benefits Of Hypothermia In Ischaemic Stroke Patients
Funder
National Health and Medical Research Council
Funding Amount
$1,048,570.00
Summary
Hypothermia, entering phase III trial in Europe, has the potential to slow brain injury after stroke. It will allow existing thrombolytic therapies which restore critical brain blood flow to be used in many more patients than currently possible. However, hypothermia will soak up valuable resources if non-selectively applied to the ~15 million patients who have a stroke each year. We aim to identify biomarkers to test which patients will benefit most and permit the best resource allocation.
Characterising A Newly Identified Mechanism Causing Elevation Of Intracranial Pressure After Acute Neurological Injury
Funder
National Health and Medical Research Council
Funding Amount
$510,905.00
Summary
Our group discovered that increased pressure on the brain (intracranial pressure – ICP) may be more common and important than has been recognised following stroke, and potentially other brain disorders. We also identified a simple potential therapy, short-duration body cooling, which completely prevents the pressure rise. In this project we will characterise the ICP rise, identify its molecular trigger and determine the best method of body cooling tor use in clinical trials in stroke patients.
Preventing Adverse Outcomes Of Neonatal Hypoxic Ischaemic Encephalopathy With Erythropoietin: A Randomised Controlled Multicentre Australian Trial
Funder
National Health and Medical Research Council
Funding Amount
$2,103,844.00
Summary
One in five babies die worldwide from Hypoxic Ischaemic Encephalopathy caused by low oxygen or blood supply to the brain around birth. Survivors often have low IQ, cerebral palsy, epilepsy or autism. Cooling the baby after birth (hypothermia) reduces the severity of brain damage, but half still die or are disabled. This randomised, controlled trial will test whether Erythropoietin (a natural hormone) can further protect and repair these babies' brains, saving lives and preventing disability.
A New Understanding Of Stroke Pathophysiology: Late Infarct Expansion May Be Under-recognised And Easily Preventable.
Funder
National Health and Medical Research Council
Funding Amount
$411,496.00
Summary
Stroke caused by a blood clot blocking a brain artery is one of the leading causes of death and disability. We recently discovered that pressure in the skull rises 24 h after stroke. Increasing evidence suggests that this causes growth of the stroke through its effects on brain blood flow. We will measure the blood flow reduction caused by the pressure rise and how frequent it is, then determine how much brain is saved and disability prevented by blocking it.
Preventing Perioperative Inadvertent Hypothermia In Adult Surgical Patients: The Development, Implementation And Evaluating Of An Evidence-based Care Bundle.
Funder
National Health and Medical Research Council
Funding Amount
$174,107.00
Summary
It is well established that keeping patients warm and preventing hypothermia before, during and after surgery leads to better outcomes. Although recommended practices for keeping a patient warm during surgery are relatively simple and inexpensive, they are often not adhered to in clinical practice. The aim of this implementation study is to improve compliance with evidence-based guidelines for the prevention of unplanned hypothermia in adult surgical patients.
Creatine, A Multi-organ Protectant Against Hypoxic Injury In The Neonate
Funder
National Health and Medical Research Council
Funding Amount
$524,802.00
Summary
The WHO estimates that up to 9 million babies suffer birth hypoxia each year, leading to 29% of global neonatal deaths, and significant rates of severe disability. We hypothesise that creatine, given as a supplement to the mothers diet during pregnancy, will protect her babies organs should low oxygen around the time of birth occur. The low cost of creatine is particularly relevant for rural and remote communities and the developing world where, currently, there are no effective therapies.
The Role Of The Osteoblast In Mediating Glucocorticoid-Induced Metabolic Dysfunction
Funder
National Health and Medical Research Council
Funding Amount
$825,254.00
Summary
Glucocorticoids (GC) exceed most other drugs in terms of numbers of patients treated and indications. Preventing or attenuating the deleterious effects of GC on fuel metabolism is therefore of great clinical significance. Our studies will create new knowledge regarding the mechanisms of GC-induced diabetes and osteoporosis, and will contribute to the development of new approaches that are essential to tackle the pressing medical problem of GC-induced disease.
The Prophylactic Hypothermia To Lessen Traumatic Brain Injury-randomised Controlled Trial : Continuation Of Funding Request
Funder
National Health and Medical Research Council
Funding Amount
$266,321.00
Summary
Traumatic brain injury (TBI) is a major cause of death and long term disability. About half with severe TBI will die or have a poor outcome. The social and economic costs to the community are high. Treatment focuses on optimising oxygen and blood flow to the brain. Cooling may protect the brain. POLAR is a randomised trial of early cooling in patients with TBI. Cooling is started within 3 hours of injury. Data about the injury management and safety is collected. Recovery is measured at 6 months.