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.
Evaluating Neonatal Intensive Care For Tiny Babies In The 2000s - Is It Still Effective, Efficient And Available?
Funder
National Health and Medical Research Council
Funding Amount
$246,333.00
Summary
Most extremely tiny babies, those of birthweight less than 1000 g, need intensive care to survive. However some survivors have substantial problems with their long-term health. Since intensive care is costly we must be sure that it is money well spent. From the late 1970s until the late 1990s in the state of Victoria neonatal intensive care has been increasingly effective, with large increases in the long-term survival rate, from 25% in 1979-80, to 73% in 1997. Its efficiency has been relatively ....Most extremely tiny babies, those of birthweight less than 1000 g, need intensive care to survive. However some survivors have substantial problems with their long-term health. Since intensive care is costly we must be sure that it is money well spent. From the late 1970s until the late 1990s in the state of Victoria neonatal intensive care has been increasingly effective, with large increases in the long-term survival rate, from 25% in 1979-80, to 73% in 1997. Its efficiency has been relatively high and stable over time, comparing favorably with many other health care programmes, both intensive and non-intensive. It has been increasingly available, with fewer than 10% of ELBW infants born outside major hospitals with intensive care nurseries, and more tiny babies offered intensive care. We now need to know if these benefits have been maintained for tiny babies born in the 2000s. Hence we need to assess the long-term health of tiny babies born in Victoria in 2005.Read moreRead less
Evaluation Of Exercise Rehabilitation For Survivors Of Intensive Care
Funder
National Health and Medical Research Council
Funding Amount
$359,282.00
Summary
Intensive care medicine has improved survival in critically ill patients. However, international literature reports poor quality of life and physical outcomes in ICU survivors compared to people of the same age. In addition, patients who require a prolonged ICU stay consume a large amount of resources. This project is testing whether an early ICU physiotherapist-directed exercise rehabilitation program continuing until after hospital discharge will improve patient's quality of life, physical fun ....Intensive care medicine has improved survival in critically ill patients. However, international literature reports poor quality of life and physical outcomes in ICU survivors compared to people of the same age. In addition, patients who require a prolonged ICU stay consume a large amount of resources. This project is testing whether an early ICU physiotherapist-directed exercise rehabilitation program continuing until after hospital discharge will improve patient's quality of life, physical function and decrease the use of health resources compared with patients' receiving standard care. Patients in the rehabilitation group will take part in a physiotherapy exercise rehabilitation program including returning to out patient classes after discharge. The physiotherapist will treat patients daily during hospital stay then twice weekly for 8 weeks after discharge. All patients will complete 2 quality of life questionnaires and physical function will be assessed using a new test developed for the acute ICU stay the 6 minute walk test, which measures how far patients can walk quickly in 6 minutes. The timed up and go test will also be used and it measures how quickly patients can get up from a chair and walk. An activity monitor, worn on the wrist, for some of the time after discharge will measure how much exercise and moving about patients are doing at home. Measurements will performed by a physiotherapist, blinded to the group to which patients were randomly allocated, on admission to the ICU (quality of life only by proxy), on discharge from the ICU, discharge from hospital and at 3, 6, 12 months after discharge. Economic evaluation will be performed to examine overall use of resources using information from the questionnaires.Read moreRead less
IMPROVING THE MANAGEMENT OF PLEURAL EFFUSIONS - FROM OUTPATIENT CLINIC TO INTENSIVE CARE.
Funder
National Health and Medical Research Council
Funding Amount
$340,891.00
Summary
Pleural effusions (PE) are collections of fluid around the lung. They are common in patients in intensive care (ICU) and in patients with metastatic cancer. Some pleural effusions resolve with medications, others require drainage procedures which have risks including lung damage, bleeding or infection which can be dangerous, especially in critically ill (ICU) patients. This proposal aims to optimise treatment decisions for PE in the ICU and cancer settings.
Delineating The Role Of Fludrocortisone And Hydrocortisone In The Management Of Patients With Septic Shock
Funder
National Health and Medical Research Council
Funding Amount
$553,664.00
Summary
Sepsis and septic shock are leading causes of morbidity and mortality globally. Steroids have been used to treat septic shock for decades. Two new trials, one using hydrocortisone vs. placebo and another using hydrocortisone plus fludrocortisone vs. placebo have produced differing results, with fludrocortisone possibly conferring a mortality benefit. My Program will investigate this evidence gap by providing critical evidence for the design and execution of a future definitive trial.
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