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.
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.
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.
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 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.
Sedation Practice In Intensive Care Evaluation (SPICE) Randomised Controlled Trial.
Funder
National Health and Medical Research Council
Funding Amount
$2,752,725.00
Summary
Almost every patient in intensive care needs sedating drugs for comfort and provision of life-saving treatment. However, sedation causes side effects including coma, delirium and agitation. There is no high-level evidence to help doctors decide which sedatives to choose and the best way to administer them. The SPICE trial will test a new approach called Early Goal-Directed Sedation based on an alternative sedative agent to see whether it delivers safer, targeted light sedation with less delirium ....Almost every patient in intensive care needs sedating drugs for comfort and provision of life-saving treatment. However, sedation causes side effects including coma, delirium and agitation. There is no high-level evidence to help doctors decide which sedatives to choose and the best way to administer them. The SPICE trial will test a new approach called Early Goal-Directed Sedation based on an alternative sedative agent to see whether it delivers safer, targeted light sedation with less delirium.Read moreRead less