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.
A Multi Centre, Randomised, Blinded, Placebo Controlled Trial Comparing Intravenous Hydrocortisone With Placebo In Critically Ill Patients With Septic Shock.
Funder
National Health and Medical Research Council
Funding Amount
$317,997.00
Summary
This study performed across Australia and New Zealand will evaluate whether hydrocortisone, a cheap drug when administered to critically ill patients with severe infection, will save lives.
STandaRd Issue TrANsfusion VersuS Fresher Red Blood Cell Use In IntenSive CarE (TRANSFUSE) – A Randomised Controlled Trial.
Funder
National Health and Medical Research Council
Funding Amount
$2,890,335.00
Summary
In Australia, blood for transfusions has a “use by” date of 42 days after collection. The actual age of blood given to patients depends on what is available at the time and the rate of usage. Some research has been done to suggest it might help patients in the intensive care unit reach a better recovery if they receive blood transfusions that are younger than this. This project will test whether patients who receive ‘fresher’ blood do better than patients who receive ‘standard issue ’ blood.
A Randomised Controlled Trial Of Normoglycaemia Versus Conventional Glycaemic Control In Intensive Care Unit Patients.
Funder
National Health and Medical Research Council
Funding Amount
$1,773,507.00
Summary
The concentration of sugar in the blood is often increased in patients in intensive care and patients with increased blood sugar levels are more likely to die. A recent study performed in a Belgian intensive care unit found that using high doses of insulin to lower blood sugars levels to normal increased the number of patients who survived. The chance of surviving to leave hospital was increased from 89% to 93%. Whilst the result is very encouraging, Intensive Care Specialists in Australia are u ....The concentration of sugar in the blood is often increased in patients in intensive care and patients with increased blood sugar levels are more likely to die. A recent study performed in a Belgian intensive care unit found that using high doses of insulin to lower blood sugars levels to normal increased the number of patients who survived. The chance of surviving to leave hospital was increased from 89% to 93%. Whilst the result is very encouraging, Intensive Care Specialists in Australia are unsure if the treatment would work in their patients because of differences in the types of patients found in intensive care units in Australia, and because of other treatment given to the patients in the Belgian study. In particular the doctors in the Belgian unit studied only patients who had had operations and gave large amounts of intravenous sugar to their patients. This is not normally done in Australian Intensive Care Units and the safety of giving high dose insulin to patients not receiving large amounts of intravenous sugar is not known. This is of particular interest as reducing blood glucose to abnormally low levels can cause serious side effects and even result in permanent brain damage. The Australian and New Zealand Intensive Care Society proposes to conduct a new study involving 4,000 patients from intensive care units in Australia and New Zealand and will study all patients regardless of whether or not they have had an operation. These patients will be randomly assigned to receive insulin to control blood sugar levels to normal or to slightly above normal levels as has been tradition in intensive care units around the world. Outcome and serious side effects will be closely monitored. The results will be available within three years of starting the study, and these are likely to influence the treatment of the majority of patients admitted to intensive care units both in Australia and worldwide.Read moreRead less
Multicentre, Open Label, Randomised, Controlled Trial Of Severe ARF Management With An Augmented Vs Normal CRRT Regimen
Funder
National Health and Medical Research Council
Funding Amount
$1,879,125.00
Summary
Sudden serious kidney failure is a major problem that frequently occurs in patients who are in Intensive Care. For these patients, their chances of survival are significantly decreased. In Australia sudden serious kidney failure is usually treated with continuous kidney support by a kidney machine. A recent study found that by using greater than normal levels of kidney support, that is , running larger volumes of fluid through the kidney machine, patients in Intensive Care Units (ICU's) may be l ....Sudden serious kidney failure is a major problem that frequently occurs in patients who are in Intensive Care. For these patients, their chances of survival are significantly decreased. In Australia sudden serious kidney failure is usually treated with continuous kidney support by a kidney machine. A recent study found that by using greater than normal levels of kidney support, that is , running larger volumes of fluid through the kidney machine, patients in Intensive Care Units (ICU's) may be less likely to die from their sudden serious kidney failure. Despite these positive findings, this high level of kidney support is not commonly used in Australian ICU's. Clearly though, if greater than normal levels of kidney support do increase the chances that individuals will live, then patients should be receiving this treatment. The Australia and New Zealand Intensive Care Society, in conjunction with The George Institute for International Health, propose to conduct a new study involving 1500 patients from ICU's throughout Australia, who require continuous kidney support due to sudden serious kidney failure. These patients will be randomly assigned so that half receive the normally used levels of kidney support and the other half receive kidney support at greater than normal levels. Patients will then be followed for three months to compare the proportions of patients who die in each group. All other outcomes and serious side effects will be closely monitored throughout the study. The results will be available to the public within four years of starting the study, and these are likely to influence the treatment of patients admitted to ICU's with sudden serious kidney failure, not only in Australia but also worldwide.Read moreRead less
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
A Randomised Controlled Trial Of The Effect Of Hydrocortisone On Mortality In Critically Ill Patients With Septic Shock
Funder
National Health and Medical Research Council
Funding Amount
$3,432,452.00
Summary
This study performed across Australia and New Zealand will evaluate whether hydrocortisone, a cheap drug when administered to critically ill patients with severe infection, will save lives.