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.
Sepsis is a major cause of hospitalization and ICU admission in Australia population corresponding to more than 15700 new cases each year. Every year more than 3000 people die from sepsis in Australia which is greater than the annual national road toll and breast, prostate or colorectal cancer. The research outlined in this proposal to study the effect of steroids and vitamin D to improve patient’s recovery from sepsis and also understand the genetic basis behind their ability to survive sepsis.
Therapeutic Potential Of Inhibiting Eph/ephrin Signalling To Repair The Vascular Endothelium In Septic Shock
Funder
National Health and Medical Research Council
Funding Amount
$664,734.00
Summary
Septic shock is a life-threatening condition usually caused by bacterial infection in the bloodstream. More than 5000 people, including 500 children, die from sepsis each year in Australia. Worldwide, it is the most significant cause of death in children. Sepsis is associated with leakage of fluid and proteins through the cells lining the blood vessels. This project will develop and test a novel treatment for sepsis which focuses on reducing this leakage by blocking the Eph/ephrin proteins.
Gene Expression Profiling In Critically Ill Patients With Septic Shock: The ADRENAL-GEPS Study
Funder
National Health and Medical Research Council
Funding Amount
$863,304.00
Summary
Sepsis refers to a whole body inflammation caused by severe infection. Approximately one in three adults admitted with septic shock die within 28 days and it is unclear whether treatment with anti-inflammatory drugs is beneficial in terms of patient survival. The aim of this study is to develop a clinical test based on gene activity that can be used to predict patient survival and also determine what the best treatment might be for individual patients.
Septic shock is a common clinical problem; it is frequently associated with kidney failure that increases mortality. We aim to determine the changes within the kidney that cause it to fail. We will establish whether oxygen levels and blood flow are altered within the kidney, and if blood is shunted through specific blood vessels, reducing flow in critical areas. Importantly, we will determine if clinical treatments used to improve kidney function cause long-term damage by reducing tissue oxygen.
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.
Severe sepsis is characterised by organ dysfunction secondary to infection, typically bacterial. We will quantify bacteria in the bloodstream of patients with septic shock, the most severe form of sepsis, to determine the relationship between bacterial load and clinical outcomes. We hypothesise that the bacterial load on presentation and the change in bacterial load over time determines survival and the evolution of organ failure in patients with septic shock.
Is Sympathetic Activation Beneficial Or Detrimental In Septic Shock?
Funder
National Health and Medical Research Council
Funding Amount
$458,755.00
Summary
Septic shock is a major cause of death in intensive care units. It is associated with large increases in sympathetic nerve activity to the heart and kidneys, which have both beneficial and harmful effects. This project will determine the responses to the increased sympathetic activity in septic shock, the causes of it and whether blocking this activation has an overall beneficial effect. This knowledge is essential before drugs that block sympathetic activation are examined in clinical studies.