Randomised Comparison Of Fluid Resuscitation With Human Albumin Solution Or Normal Saline Among Critically Ill Patients
Funder
National Health and Medical Research Council
Funding Amount
$611,728.00
Summary
Human albumin solution is widely used for the emergency treatment of severely ill patients requiring fluid replacement, both in Australia and worldwide. However, a recent report suggests that compared to the other standard treatment (salt solution), the use of human albumin solution may be associated with a higher death rate (about six additional deaths among every one hundred patients treated). But, this report was based on data from a relatively small number of patients among whom there was a ....Human albumin solution is widely used for the emergency treatment of severely ill patients requiring fluid replacement, both in Australia and worldwide. However, a recent report suggests that compared to the other standard treatment (salt solution), the use of human albumin solution may be associated with a higher death rate (about six additional deaths among every one hundred patients treated). But, this report was based on data from a relatively small number of patients among whom there was a relatively small number of deaths, and there is widespread uncertainty among doctors about the reliability of the evidence and the implications for patient care. This is reflected in the large difference between intensive care units in the use of human albumin solution (in Australia, its use ranges from 10-90% of all patients needing fluid). Human albumin solution costs, about thirty times more than salt solution, and during 1998 more than 200,000 bottles of human albumin solution were administered to patients in Australia, at a cost of about A$35 million. In an effort to provide definitive evidence about the effects (and cost-effectiveness) of fluid replacement with human albumin solution, the Australia and New Zealand Intensive Care Society, in collaboration with the Australian Red Cross Blood Services and the Institute for International Health, has proposed the conduct of new large-scale study (SAFE - Saline vs Albumin Fluid Evaluation). This study will involve 7,000 patients from 15 intensive care units in Australia and New Zealand. These patients (all of whom require fluid replacement) will be randomly assigned to receive either human albumin solution or salt solution and outcome in terms of deaths and other serious events will be monitored over 28 days. Results will be available within 2 years of starting the study, and these are likely to influence the care of the majority of seriously ill patients admitted to intensive care units worldwide.Read moreRead less
Hypertonic Saline (HTS) In Head Injured Patients - A Multicentre, Prehospital, Prospective Randomised Clinical Trial
Funder
National Health and Medical Research Council
Funding Amount
$247,269.00
Summary
Head injury is common in patients with major trauma, many of whom are young adults. The extent of head injury has a major influence on patient outcome. Low blood pressure after trauma worsens the extent of brain injury by decreasing its blood supply at a critical stage. Much of this secondary brain injury occurs before the patient reaches hospital. Hypertonic saline (HTS) is an intravenous salt solution which has been used in intensive care patients for many years to decrease brain swelling in h ....Head injury is common in patients with major trauma, many of whom are young adults. The extent of head injury has a major influence on patient outcome. Low blood pressure after trauma worsens the extent of brain injury by decreasing its blood supply at a critical stage. Much of this secondary brain injury occurs before the patient reaches hospital. Hypertonic saline (HTS) is an intravenous salt solution which has been used in intensive care patients for many years to decrease brain swelling in head injured patients. We know that HTS can be given to patients before they reach hospital, is safe, and acts by rapidly increasing blood pressure and decreasing brain swelling. Accordingly HTS may minimise secondary brain injury and lead to increased survival. Importantly, HTS is likely to dramatically improve neurological function of survivors without any significant risk of side effects. This study is designed to determine the effectiveness of prehospital HTS in head injured trauma patients with traumatic coma and low blood pressure.Read moreRead less
Novel Interventions For The Diverse Population Of Australians With Bronchiectasis
Funder
National Health and Medical Research Council
Funding Amount
$726,822.00
Summary
Bronchiectasis is a chronic lung condition in which infection causes wheeze, breathlessness, fatigue and sputum production - markedly reducing quality of life and requiring repeated hospital admissions. Risk of hospitalisation due to the disease is up to 9-fold higher in Indigenous vs other Australians. This research will examine two new, low-cost therapies with excellent potential to treat bronchiectasis: a new antibiotic, Azithromycin, and a mucus-clearance agent, hypertonic saline.
Amyloid Precursor Proteins Novel Role In Alzheimers Disease Through Regulating Neuronal Iron Homeostasis.
Funder
National Health and Medical Research Council
Funding Amount
$949,667.00
Summary
Our group has discovered a novel role of amyloid precursor protein (APP) in cellular iron balance. The smallest form of APP, prevalently found in the brain, is able to convert a damaging iron variety (Fe2+) into the safer Fe3+. Alternative, larger, forms of APP are found to inhibit this effect. This project will establish how APP controls iron homeostasis within brain neuronal cells and how this activity is impaired in disease, thus development a mechanism for diagnostic tests and therapeutics.