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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.
Rapidly giving intravenous fluid to prevent or treat shock (fluid resuscitation) is one of the commonest treatments given to critically ill patients. Current guidelines recommend crystalloid solutions but it is unknown whether any particular crystalloid is better than others. This trial will determine whether the use of one of two crystalloid fluids, saline or PlasmaLyte, reduces the risk of organ injuries, such as kidney failure, and improves patients chances of surviving critically illness.
Optimisation By Platform Trial Involving Multiple Interventions With Simultaneous Evaluation In Community Acquired Pneumonia (OPTIMISE-CAP)
Funder
National Health and Medical Research Council
Funding Amount
$4,413,145.00
Summary
In Australia severe Community Acquired Pneumonia is responsible for more than 7000 ICU admissions and 1400 deaths each year. This trial will determine the optimal treatments among existing choices of therapy related to choice of antibiotic, ventilator strategy and modulation of the immune system. The trial uses new methods to answer more research questions as quickly as possible.
Functional Electrical Stimulation Assisted Cycling (eStimCycle):A Novel Intervention To Improve Outcomes In The Critically Ill
Funder
National Health and Medical Research Council
Funding Amount
$868,811.00
Summary
The legacy of critical illness leaves millions of survivors worldwide with long lasting deficits in physical and brain function as well as anxiety, depression and post-traumatic stress disorder. Early rehabilitation may prevent or minimise these effects. This study evaluates the effectiveness of functional electrical stimulation of muscles with assisted in-bed cycling (eStimCycle) on muscle bulk, strength, physical and brain function at hospital discharge, 6 and 12 months.
Protein Absorption And Kinetics In Critical Illness
Funder
National Health and Medical Research Council
Funding Amount
$1,233,268.00
Summary
This experienced & productive group plan to perform a number of interrelated studies in patients with critical illness the aim of which will be to ascertain protein absorption & kinetics, & the relationship between protein intake & muscle physiology. The goal is to lay the groundwork for an understanding of protein in the nutritional support of these patients which will help us to later establish the optimum amount & type of protein to improve muscle strength, functional outcomes & survival.
The Augmented Versus Routine Approach To Giving Energy Trial (TARGET)
Funder
National Health and Medical Research Council
Funding Amount
$3,696,854.00
Summary
Critically ill patients are routinely underfed. The investigators have developed a simple strategy that reliably delivers 100% of caloric goals. The strategy is to substitute standard nutrient with energy dense nutrient and deliver it at the same rate. The aim of this study is to determine the effect of increased calorie delivery on long-term survival and function following critical illness. A 4000-patient, multicentre, double-blind, randomised, clinical trial will be performed.
Treatment Of Invasively Ventilated Adults With Early Activity And Mobilisation
Funder
National Health and Medical Research Council
Funding Amount
$1,467,137.00
Summary
The sickest patients in intensive care units (ICUs) receive prolonged, invasive support for their breathing. This is currently managed with complete bed rest, and results in severe muscle weakness, increased duration of hospital stay and poor recovery. We have found that early activity and mobilisation during invasive breathing support is safe and may improve survival and recovery. We will test early activity and mobilisation in a large randomised controlled trial of 750 ICU patients.
BLING III: A Phase III Randomised Controlled Trial Of Continuous Beta-lactam Infusion Compared With Intermittent Beta-lactam Dosing In Critically Ill Patients
Funder
National Health and Medical Research Council
Funding Amount
$3,269,943.00
Summary
This Australian-led trial of global significance will provide definitive clinical evidence of the optimal method for treating patients with severe sepsis using beta-lactam antibiotics. The trial will compare whether continuous infusion of beta-lactam antibiotics improves outcomes for patients compared with standard intermittent dosing. The potential significance of this trial is that it may lead to a simple and cost-effective intervention to improve survival for patients with severe infections.
Causes And Management Of Abnormally Elevated Blood Glucose Concentrations In The Critically Ill
Funder
National Health and Medical Research Council
Funding Amount
$430,770.00
Summary
Increased glucose concentrations occur commonly in ICU patients and are associated with increased mortality and morbidity. There is a need to improve the understanding of the causes underlying so-called 'critical illness induced hyperglycaemia' as well as new therapies to reduce blood glucose in this group. The proposed studies will focus on the potential role of incretin hormones, which have the capacity to stimulate insulin without increasing the risk of abnormally low blood glucose levels.