Restrictive Versus Liberal Fluid Therapy In Major Abdominal Surgery: The RELIEF Trial
Funder
National Health and Medical Research Council
Funding Amount
$2,477,820.00
Summary
Major surgery can result in serious complications, some of which lead to permanent disability and early death. All patients undergoing major surgery require intravenous fluids to maintain a healthy circulation, but too much fluid can cause tissue swelling (oedema) and "drown" the vital organs. There are probable benefits of a restrictive IV fluid regimen. This could have major benefits to patients having surgery.
Advances in anaesthesia and perioperative medicine have resulted in safer care and better quality outcomes for patients having major surgery. Such advances need to be based on good quality evidence, coming from large randomised clinical trials. This research program will study, publish and disseminate information from studies of new drugs and techniques that improve the care of patients undergoing surgery.
Safer Fluid Resuscitation- Which (type), What (to Expect) And How (mechanisms)
Funder
National Health and Medical Research Council
Funding Amount
$189,384.00
Summary
Intravenous fluid administration to patients is the most common clinical intervention, often done to help sick patents get better, however paradoxically it is associated with worsening oxygen levels and increased death rates. In humans and animal I have demonstrated increased respiratory dysfunction with its administration. This study aims to understand the efficacy, compare different types of fluids and establish safer fluid administration thereby decreasing patient suffering and death rates.
Lung Injury: Influence Of Sodium, Water, Albumin, Gravity And Body Position
Funder
National Health and Medical Research Council
Funding Amount
$117,331.00
Summary
Although patients with poor oxygenation often require mechanical ventilation, only therapies that reduce lung damage improve outcome whereas therapies that improve oxygenation have not been shown to improve outcome. This project will examine the role of two common interventions in critically ill patients, fluid resuscitation and posture change, on lung injury. It is anticipated this will lead to clinical trials that will further improve survival in ventilated patients with respiratory failure.
Regulation Of The Activity And The Surface Expression Of Sodium Channels
Funder
National Health and Medical Research Council
Funding Amount
$466,980.00
Summary
The regulation of transport of salt into and out of the body is essential for the maintenance of blood pressure, and for the maintenance of the correct amount of fluid in the respiratory passages and gut. A critical component of the mechanism by which the body transports salt are sodium channels. Overactivity of these channels leads to increased blood pressure and clogging of the gut and the bronchi due to thick and sticky secretions. Reduced activity leads to abnormally low blood pressure, as w ....The regulation of transport of salt into and out of the body is essential for the maintenance of blood pressure, and for the maintenance of the correct amount of fluid in the respiratory passages and gut. A critical component of the mechanism by which the body transports salt are sodium channels. Overactivity of these channels leads to increased blood pressure and clogging of the gut and the bronchi due to thick and sticky secretions. Reduced activity leads to abnormally low blood pressure, as well as to accumulation of fluid in the lungs such as occurs in influenza and in altitude sickness. The present project will examine the mechanisms by which sodium channels are regulated. It will particularly focus on the mechanisms by which sodium channels are switched off when the salt content of cells is too high.Read moreRead less
Regulation Of Epithelial Sodium Channels By Caveolin
Funder
National Health and Medical Research Council
Funding Amount
$408,391.00
Summary
Abnormal sodium absorption in the kidney, gut and lung is implicated in hypertension, cystic fibrosis and pulmonary oedema. Epithelial Na+ channels are a key component of the mechanism by which these organs absorb sodium. The project will investigate the mechanisms by which the activity of these channels is controlled and is intended to discover new approaches to treating abnormal sodium absorption.
Fluid intake is essential for survival. Disorders of thirst whether they be excessive or inadequate have dire conseqences as evidenced in recent heat waves in Europe and Indiawhere thousands of lives were lost primarily in the elderly whose thirst mechanisms are often disrupted. The excessive fluid intake, seen in psychotic disorders such as schizophrenia, is equally damaging. Much of the research over the last 50 years has concentrated on the hypothalamic regulation of thirst. This project will ....Fluid intake is essential for survival. Disorders of thirst whether they be excessive or inadequate have dire conseqences as evidenced in recent heat waves in Europe and Indiawhere thousands of lives were lost primarily in the elderly whose thirst mechanisms are often disrupted. The excessive fluid intake, seen in psychotic disorders such as schizophrenia, is equally damaging. Much of the research over the last 50 years has concentrated on the hypothalamic regulation of thirst. This project will attempt, for the first time, to define the location in the cerebral cortex of the drive to ingest water (perception of thirst).Read moreRead less
Individual Patient Data Meta-analysis Of Randomised Control Trials In Fluid Resuscitation
Funder
National Health and Medical Research Council
Funding Amount
$85,027.00
Summary
I am a registered nurse focused in critical care research. I have an interest in the area of fluid resuscitation. My aim is to carry out an individual patient data meta-analysis (IPDMA) on randomised controlled trials (RCTs) in fluid resuscitation. The IPDMA will consist of two of the largest critical care trials; Saline Vs Albumin fluid Evaluation (SAFE) study and the Crystalloid Vs Starch (CHEST) study, to add further evidence to the currently limited fluid resuscitation literature.
Interactions Between Systems That Control Sodium Channels In Renal Epithelia
Funder
National Health and Medical Research Council
Funding Amount
$227,036.00
Summary
The transport of sodium ions by the kidney, gut and lungs not only regulates blood pressure, it also regulates the amount of fluid in the gut and in the lungs. One of the most important proteins that underlie the transport of sodium in these tissues is the so-called epithelial sodium channel. The activity of these epithelial sodium channels is regulated by a wide variety of systems. Some of these regulatory systems act in response to changes in the body's requirements for sodium transport. Other ....The transport of sodium ions by the kidney, gut and lungs not only regulates blood pressure, it also regulates the amount of fluid in the gut and in the lungs. One of the most important proteins that underlie the transport of sodium in these tissues is the so-called epithelial sodium channel. The activity of these epithelial sodium channels is regulated by a wide variety of systems. Some of these regulatory systems act in response to changes in the body's requirements for sodium transport. Others act in response to changes in capacity of cells in which the sodium channels are found to continue transporting sodium. In this project we will study the mechanisms that regulate the activity of the epithelial sodium channels, and in particular, how these mechanisms interact so as to maintain a level of sodium channel activity that is appropriate to both the needs of the organism and to the needs of the sodium transporting cells. The outcomes of this project will be improved understanding of the function of the kidney, gut and lungs in both health and disease. It may also lead to novel drug targets for treatment of major diseases in which the activity of sodium channels is abnormal. These disease include hypertension, cystic fibrosis, pulmonary oedema and influenza.Read moreRead less