Advances in anaesthesia and perioperative medicine have resulted in safer care and better quality outcomes for patients having major surgery. Such advances need to be based on good quality evidence, coming from large randomised clinical trials. This research program will study, publish and disseminate information from studies of new drugs and techniques that improve the care of patients undergoing surgery.
Nitrous Oxide Anaesthesia And Cardiac Morbidity In Major Surgery
Funder
National Health and Medical Research Council
Funding Amount
$2,952,623.00
Summary
Nitrrous oxide is an anaesthtic gas that has been in use for more than 160 years. It has been considered a safe and cheap drug, but newer anaesthetic drugs and improvements in technology provide alternatives that might be safer. Our recent research has found some potentialy serious (but rare) complications associated with nitrous oxide. These are more likely to occur in people with existing heart disease. The purpose of this study is to investigate the safety of nitrous oxide in such people. Whe ....Nitrrous oxide is an anaesthtic gas that has been in use for more than 160 years. It has been considered a safe and cheap drug, but newer anaesthetic drugs and improvements in technology provide alternatives that might be safer. Our recent research has found some potentialy serious (but rare) complications associated with nitrous oxide. These are more likely to occur in people with existing heart disease. The purpose of this study is to investigate the safety of nitrous oxide in such people. When considering its widespread use in about 90% of all surgery in Australia (and around the world), small differences in outcome would have major implications for healthcare delivery. A large well-designed study is necessary to answer this question. We plan to study 7,000 patients having major surgery from around the world.Read moreRead less
PREOPERATIVE RISK FACTORS, ADVERSE OUTCOMES AND EFFECTS OF EPIDURAL AND SPINAL ANAESTHESIA
Funder
National Health and Medical Research Council
Funding Amount
$66,110.00
Summary
Anaesthesia and major surgery in patients with coexisting important medical problems present a major challenge to health professionals to avoid and minimise life threatening complications of such surgery. Accurate prediction of which patients are likely to fare badly, and therefore need more intensive peri-operative care and supervision, and knowing definitively whether epidural techniques really do improve the outcome of surgery are issues of central importance in the practice of anaesthesia. P ....Anaesthesia and major surgery in patients with coexisting important medical problems present a major challenge to health professionals to avoid and minimise life threatening complications of such surgery. Accurate prediction of which patients are likely to fare badly, and therefore need more intensive peri-operative care and supervision, and knowing definitively whether epidural techniques really do improve the outcome of surgery are issues of central importance in the practice of anaesthesia. Providing clear answers to both questions requires careful analysis of large amounts of data in which systematic and random errors have been minimised. Databases from well-designed and supervised clinical trials represent an invaluable resource in this regard because they have been compiled through the rigorous application of unambiguous definitions and protocols during the process of recording, coding and entering the information. By bringing together the resources and expertise of the MASTER Trial group and the Collaborative Overview of Randomised of Trials of Regional Anaesthesia (CORTRA), both of which are major international projects led from the Australasian region, we have a unique opportunity to provide exceptionally robust answers to some of the most challenging issues in anaesthesia. The combined study of two large international databases will provide a more precise quantitative analysis of the components of preoperative risk and their relationship to life threatening post operative complications, and the possible role of epidural and spinal anaesthesia in minimising risk by reducing the frequency of these complications.Read moreRead less
Evaluation Of Aspirin And Tranexamic Acid In Coronary Artery Surgery: The ATACAS Trial
Funder
National Health and Medical Research Council
Funding Amount
$1,185,000.00
Summary
This large study will compare two types of drug treatment in 4600 patients undergoing heart surgery, to see whether either can reduce the risk of death or major complications. The complications after surgery we are measuring include heart attack, stroke, lung embolism, bleeding around the heart, breathing failure, kidney failure, major haemorrhage, serious wound infection, and death. The first drug being tested is low-dose aspirin. It is believed that aspirin can reduce the risk of a further hea ....This large study will compare two types of drug treatment in 4600 patients undergoing heart surgery, to see whether either can reduce the risk of death or major complications. The complications after surgery we are measuring include heart attack, stroke, lung embolism, bleeding around the heart, breathing failure, kidney failure, major haemorrhage, serious wound infection, and death. The first drug being tested is low-dose aspirin. It is believed that aspirin can reduce the risk of a further heart attack or stroke in patients with pre-existing heart disease. There is some evidence that aspirin may have similar effects in people undergoing heart surgery, but such use is constrained by a concern that there may be an increased risk of bleeding after surgery. For this reason, most patients having heart surgery are advised to stop their aspirin about one week before surgery. But patients could be missing out on aspirin's beneficial effects. At present, we do not know whether the benefits of aspirin could outweigh the risk of excesive bleeding. The second drug being tested is tranexamic acid. This drug prevents blood clot being broken down at the stitching sites of surgery, and probably reduces the amount of blood loss during and after heart surgery. It is known that use of this drug reduces the need for a blood transfusion. It is possible that this could avoid other more serious complications after surgery. Both of these drugs are being tested individually, but in addition we are testing whether they may have an extra beneficial effect when used together. The study is being done by a partnership of anaesthetitsts and surgeons at more than 20 hospitals around Australia.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.
The Australian and New Zealand Intensive Care Society Clinical Trials Group (ANZICS CTG) provides the only coordinated clinical trials research strategy for intensive care medicine in Australia and one of the few in the world. Its core business is the design and conduct of world-class multi-centre randomised controlled trials. It is clear that a national methods centre providing dedicated epidemiology, database and statistical expertise, together with improved infrastructure to support large cli ....The Australian and New Zealand Intensive Care Society Clinical Trials Group (ANZICS CTG) provides the only coordinated clinical trials research strategy for intensive care medicine in Australia and one of the few in the world. Its core business is the design and conduct of world-class multi-centre randomised controlled trials. It is clear that a national methods centre providing dedicated epidemiology, database and statistical expertise, together with improved infrastructure to support large clinical trials, will ensure the future of the group and enable greater productivity.Read moreRead less
A Multi-centre RCT Of An Open Lung Strategy Including Permissive Hypercapnia, Alveloar Recruitment, And Low Airway Pressure In Patients With ARDS
Funder
National Health and Medical Research Council
Funding Amount
$1,041,070.00
Summary
Acute respiratory distress syndrome (ARDS) is a severe inflammatory condition of the lungs that complicates many critical illnesses and is associated with high mortality. Inappropriate settings of the mechanical ventilator can lead to a worsening outcome. The aim of this Phase II study is to compare the clinical efficiency of a novel ventilation strategy to reduce the duration of mechanical ventilation in survivors, including several lung protective settings, to that of current standard care.
The Australasian Resuscitation In Sepsis Evaluation - Randomised Controlled Trial
Funder
National Health and Medical Research Council
Funding Amount
$2,424,807.00
Summary
Patients with severe infections often present to Emergency Departments and early treatment with particular fluids, blood transfusions and stimulants, may improve survival rates. To determine whether early treatment is safe and effective in reducing deaths, the Australian and New Zealand Intensive Care Society Clinical Trials Group, in conjunction with the Australasian College of Emergency Medicine, plan to perform a large trial of early goal directed therapy in patients with severe infections.
I am an intensive care physician, clinician and researcher, interested in studying new therapies to improve outcomes in patienst with acute trauma, sepsis and lung injury. A main focus is independent phase 111 clinical trials in critically ill patients