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.
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.
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.
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
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
Impact Of Gastrointestinal Dysmotility On Enteral Nutrition In The Critically Ill
Funder
National Health and Medical Research Council
Funding Amount
$533,792.00
Summary
Critically ill patients require nutrition for optimum recovery. Ideally, this is provided via the gut, but oesophageal reflux, slow gastric emptying and small intestinal dysfunction frequently prevent adequate delivery of nutrients to these patients, exposing them to complications such as pneumonia and gastrointestinal bleeding. The work performed by the applicants will improve the ability of doctors in the Intensive Care Unit to feed patients and prevent the development of such complications.
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