Defining Regional Lung Mechanics To Improve Lung Protective Ventilation Strategies In Newborn Infants
Funder
National Health and Medical Research Council
Funding Amount
$287,321.00
Summary
Over 3000 newly born infants require mechanical ventilation in Australia every year. The majority are very premature infants. About 30% of ventilated infants develop serious ventilator induced lung injury. Minimising such lung injury with improved techniques of ventilation which can protect the lung from injury will reduce the considerable short and long term health burden of this population.
RCT Of Headbox Oxygen Vs CPAP For Neonatal Respiratory Distress In Non-tertiary Hospitals
Funder
National Health and Medical Research Council
Funding Amount
$225,500.00
Summary
Each year in NSW hundreds of babies are transferred from local general hospital nurseries to a hospital with Neonatal Intensive Care Unit (NICU) because of breathing difficulties. Frequently, mothers are unable to accompany their babies at the time of transfer, leading to stress. When a mother is eventually transferred she is often separated from her partner and local supports causing further anxiety. In addition, if a baby has to be transferred, invasive procedures may be needed to ensure safet ....Each year in NSW hundreds of babies are transferred from local general hospital nurseries to a hospital with Neonatal Intensive Care Unit (NICU) because of breathing difficulties. Frequently, mothers are unable to accompany their babies at the time of transfer, leading to stress. When a mother is eventually transferred she is often separated from her partner and local supports causing further anxiety. In addition, if a baby has to be transferred, invasive procedures may be needed to ensure safety. Currently, babies who need oxygen in a local hospital are placed in a crib with a clear plastic box around their head and oxygen is run into the box (headbox oxygen). There is an alternative method of providing oxygen called CPAP (Continuous Positive Airway Pressure). This involves giving the oxygen directly into the baby's nose via soft rubber prongs. CPAP has been used since the 1970's. It is the main form of respiratory support for infants in many NICUs in Australia and the world. There is some evidence that death and lung disease may be reduced. However, the babies in these studies are sicker and smaller than babies in local hospital nurseries. CPAP is used in some local nurseries in New Zealand, however no studies have been done to see if CPAP reduces the need for inter-hospital transfer. The study will involve hospitals that have been selected because of their level of on site medical and nursing staff. These hospitals will have support and advice from two NICUs that use CPAP as their main form of respiratory support. Babies who need oxygen will be randomly allocated to either have headbox oxygen or CPAP. If the baby becomes so unwell such that certain preset criteria are met, the baby will be transferred to a NICU in the usual way. If CPAP safely reduces the need for inter-hospital transfer, many parents will be saved the anxiety associated with transfer, and the separation it often causes.Read moreRead less
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
Understanding The Mechanisms Of Bleeding And Clotting Complications For Children On Extracorporeal Circuits.
Funder
National Health and Medical Research Council
Funding Amount
$1,113,385.00
Summary
Extracorporeal Membrane Oxygenation (ECMO) is advanced life support, which can save critically ill children. Significant bleeding occurs in 39%; clotting in 31% of children on ECMO; stroke in 12%. The biggest barrier to reducing these complications is the lack of understanding of how the bleeding/clotting system works in ECMO. This unique proposal uses the largest paediatric ECMO population in Australia and a multidisplinary expert team to develop a mechanistic understanding of these issues.
Evaluation Of The Incorporation Of WHO Guidelines Into Post-graduate Medical Curriculum; The Impact On Quality Of Care
Funder
National Health and Medical Research Council
Funding Amount
$130,704.00
Summary
There is abundant evidence that many patients do not receive medical treatments of proven effectiveness. This is even more apparent in developing countries. Strategies to improve use of proven treatments is needed. Our research aims to evaluate an educational program for doctors in Lao PDR, based on World Health Organisation guidelines for the care of sick children in hospitals, including the impact on the knowledge of doctors and on the quality of care in the hospitals in which they work.
A Randomised Controlled Trial Of A Community-based Weight Management Intervention In Obese Adolescents
Funder
National Health and Medical Research Council
Funding Amount
$79,534.00
Summary
This research will explore various aspects of managing overweight and obesity in adolescence, including a review of previous studies. The central focus will be participants' weight, health and behavioral outcomes in a randomised controlled trial of a community-based weight management program for 13-16 year olds. A focus group study will be conducted to increase understanding of parent-adolescent communication regarding overweight and the decision to seek treatment.
Nitric Oxide On Cardio Pulmonary Bypass In Congenital Heart Disease
Funder
National Health and Medical Research Council
Funding Amount
$1,878,889.00
Summary
Children undergoing open heart surgery on a heart lung machine can experience serious side effects from the exposure to the artificial circulation during surgery and may have either prolonged need for life support in intensive care or even may suffer from long term complications. In this study we investigate the use of a new approach using nitric oxide, a anti-inflammatory gas, during surgery to reduce these side effects.
Necrotising enterocolitis (NEC) is a devastating bowel condition afflicting almost 1 in 10 of very preterm babies. About a third of babies with NEC do not survive. Currently, there is no cure. We propose the use of stem-like cells from the human placenta as a targeted therapy for NEC, working by minimising gut damage and accelerating gut repair.
Nasal Highflow For Paediatric Acute Hypoxic Respiratory Failure
Funder
National Health and Medical Research Council
Funding Amount
$2,627,819.00
Summary
The burden of respiratory disease in children requiring intensive care admission is increasing despite better quality care in hospitals. This study investigates a new method, called nasal high flow, to support the breathing of children, that can be provided in regular children's wards in regional and metropolitan hospitals. The study anticipates to demonstrate that early intervention with nasal high flow reduces the need for intensive care admission.
Neuroprotective Role Of Sulphate Among Preterm Babies (SuPreme Study)
Funder
National Health and Medical Research Council
Funding Amount
$749,338.00
Summary
Magnesium sulphate administered to mothers shortly before preterm birth, reduces the risk of cerebral palsy. The mechanism of its neuroprotective effect is unknown, and our studies suggest sulphate is the protective element. Preterm babies rapidly become sulphate deficient, and magnesium sulphate mitigates this deficiency in most infants. In this study we will investigate whether low blood sulphate levels at 1 week of age correlate with cerebral palsy.