Towards An Improved Understanding Of The Effect Of A Speaking Valve On Lung Volumes And Communication In The Critically Ill Tracheostomised Patient
Funder
National Health and Medical Research Council
Funding Amount
$45,795.00
Summary
Patients that require life support in intensive care often have breathing tubes in their neck. This means they are generally left without a voice for days, weeks, even months. Speaking valves meant for talking are not used much due to fears of harm to the lungs. Our study is looking at how much air is in the lungs when using this valve. Data so far suggest that the valve is in fact helping the lungs. The outcomes of this study may lead to most of these critically ill patients having a voice.
A Cluster Randomised Controlled Trial Of Selective Decontamination Of The Digestive Tract In Critically Ill Patients
Funder
National Health and Medical Research Council
Funding Amount
$4,113,393.00
Summary
Sepsis is the most common cause of death in intensive care patients. Selective Decontamination of the Digestive Tract (SDD) is a treatment to reduce the risk of infection and improve survival for these patients. Many trials suggest SDD works but there has not been widespread uptake due to concerns that SDD will increase antibiotic resistance.rates. This trial will provide a definitive answer. If SDD reduces mortality without increasing antibiotic resistance, the study will have a global impact.
Intensive Care Management And Quality Of Survival Of Acute Respiratory Distress Syndrome
Funder
National Health and Medical Research Council
Funding Amount
$307,946.00
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 and morbidity. Although intensive care admission and mechanical ventilation provide life-saving support during ARDS, they can lead to poor long term outcome. The aim of this program is to compare the clinical efficiency of new strategies in ICU to that of current standard care and to improve the quality of survival of patients w ....Acute respiratory distress syndrome (ARDS) is a severe inflammatory condition of the lungs that complicates many critical illnesses and is associated with high mortality and morbidity. Although intensive care admission and mechanical ventilation provide life-saving support during ARDS, they can lead to poor long term outcome. The aim of this program is to compare the clinical efficiency of new strategies in ICU to that of current standard care and to improve the quality of survival of patients with ARDS.Read moreRead less
Separating The Adverse Neurodevelopmental Consequences Of Mechanical Ventilation And Postnatal Steroids In Preterm Lambs
Funder
National Health and Medical Research Council
Funding Amount
$1,752,863.00
Summary
Extremely premature infants often develop severe breathing difficulties and need the help of a machine to breathe. Certain steroids help to mature the lung and allow the baby to breathe on his own without help. However, both steroids and long periods on breathing machines may interfere with normal brain development. This study will help doctors to weigh up the long-term risks and benefits of giving a baby steroids to help them breathe on their own versus continuing mechanical ventilation without ....Extremely premature infants often develop severe breathing difficulties and need the help of a machine to breathe. Certain steroids help to mature the lung and allow the baby to breathe on his own without help. However, both steroids and long periods on breathing machines may interfere with normal brain development. This study will help doctors to weigh up the long-term risks and benefits of giving a baby steroids to help them breathe on their own versus continuing mechanical ventilation without steroids.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
Does Increased Non-Linear Behavior Caused By Dynamic Variables Increase Ventilatory-Induced Lung Injury (VILI)?
Funder
National Health and Medical Research Council
Funding Amount
$109,625.00
Summary
Acute lung injury (ALI) is precipitated by a variety of different insults, either directly to the lung or elsewhere to the body. Approximately 50% of the patients die. ALI is characterized by an increase in the leakiness of the barrier that normally separates the blood from the airspaces. The fluid which consequently floods the airspaces not only makes it difficult for patients to adequately obtain oxygen, but also dramatically increases the work of breathing by changing the surface forces withi ....Acute lung injury (ALI) is precipitated by a variety of different insults, either directly to the lung or elsewhere to the body. Approximately 50% of the patients die. ALI is characterized by an increase in the leakiness of the barrier that normally separates the blood from the airspaces. The fluid which consequently floods the airspaces not only makes it difficult for patients to adequately obtain oxygen, but also dramatically increases the work of breathing by changing the surface forces within the lungs. As a result, the patients must be mechanically ventilated. However, the very act of using a positive pressure to inflate the lungs often creates further damage, either through repeated opening and closing of collapse tissue or through its over distension. Ventilatory-induced lung injury (VILI), in itself is estimated to contribute to ~30% of the mortality. The best way shown to minimize VILI is through the use of small programmed breaths so as not to overinflate the lungs while still allowing adequate gas exchanges, superimposed upon a background pressure, in order to pre-inflate the lungs and prevent them from repeatedly collapsing. A remaining problem is that just as a rubber band changes its elasticity as it is stretched, so too the lung changes its mechanical properties during distension. Moreover, the lung is considerably more complex since different regions have different elasticities, which change differentially as air flows in and out of them. Airflow in turn depends on regional differences in the location, size, and number of conducting airways. Indeed, we have recently shown for the first time that dynamic changes in lung mechanics may contribute to VILI in patients, despite the use of safe ventilation modalities. This application proposes to examine the extent to which dynamic changes in lung mechanic contribute to VILI in an animal model, as a prelude to more costly, large scale clinical trials aimed at improving mortality.Read moreRead less