A Randomised Controlled Trial Of The Effect Of Hydrocortisone On Mortality In Critically Ill Patients With Septic Shock
Funder
National Health and Medical Research Council
Funding Amount
$3,432,452.00
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.
Optimisation By Platform Trial Involving Multiple Interventions With Simultaneous Evaluation In Community Acquired Pneumonia (OPTIMISE-CAP)
Funder
National Health and Medical Research Council
Funding Amount
$4,413,145.00
Summary
In Australia severe Community Acquired Pneumonia is responsible for more than 7000 ICU admissions and 1400 deaths each year. This trial will determine the optimal treatments among existing choices of therapy related to choice of antibiotic, ventilator strategy and modulation of the immune system. The trial uses new methods to answer more research questions as quickly as possible.
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.
Treatment Of Invasively Ventilated Adults With Early Activity And Mobilisation
Funder
National Health and Medical Research Council
Funding Amount
$1,467,137.00
Summary
The sickest patients in intensive care units (ICUs) receive prolonged, invasive support for their breathing. This is currently managed with complete bed rest, and results in severe muscle weakness, increased duration of hospital stay and poor recovery. We have found that early activity and mobilisation during invasive breathing support is safe and may improve survival and recovery. We will test early activity and mobilisation in a large randomised controlled trial of 750 ICU patients.
A Randomised, Placebo-controlled Trial Of Erythropoietin In ICU Patients With Traumatic Brain Injury
Funder
National Health and Medical Research Council
Funding Amount
$1,950,735.00
Summary
Patients who suffer a moderate or severe head injury (traumatic brain injury) have a 50% chance of having a long term neurological disability or death. Erythropoietin is a medication which encourages red blood cell formation but its other beneficial effects are likely to improve outcomes after traumatic brain injury. This study will examine the safety and effects of erythropoietin on long term neurological function in patients who have suffered a traumatic brain injury.
BLING III: A Phase III Randomised Controlled Trial Of Continuous Beta-lactam Infusion Compared With Intermittent Beta-lactam Dosing In Critically Ill Patients
Funder
National Health and Medical Research Council
Funding Amount
$3,269,943.00
Summary
This Australian-led trial of global significance will provide definitive clinical evidence of the optimal method for treating patients with severe sepsis using beta-lactam antibiotics. The trial will compare whether continuous infusion of beta-lactam antibiotics improves outcomes for patients compared with standard intermittent dosing. The potential significance of this trial is that it may lead to a simple and cost-effective intervention to improve survival for patients with severe infections.
Saving Money And Saving Lives: Integrating Comparative Effectiveness Trials And Translational Research In Critically Ill Patients
Funder
National Health and Medical Research Council
Funding Amount
$338,938.00
Summary
I am a full-time Intensive Care Specialist in Sydney who combines clinician duties with research. My research is the design and conduct of large trials that have changed and will continue to change the management of critically ill patients around the world. I led two of the largest trials ever conducted in critically ill patients and have recently been funded to lead a further even larger trial. The Practitioner Fellowship will allow me to continue and expand this essential research.
STandaRd Issue TrANsfusion VersuS Fresher Red Blood Cell Use In IntenSive CarE (TRANSFUSE) – A Randomised Controlled Trial.
Funder
National Health and Medical Research Council
Funding Amount
$2,890,335.00
Summary
In Australia, blood for transfusions has a “use by” date of 42 days after collection. The actual age of blood given to patients depends on what is available at the time and the rate of usage. Some research has been done to suggest it might help patients in the intensive care unit reach a better recovery if they receive blood transfusions that are younger than this. This project will test whether patients who receive ‘fresher’ blood do better than patients who receive ‘standard issue ’ blood.
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
Re-EValuating The Inhibition Of Stress Erosions (REVISE): Gastrointestinal Bleeding Prophylaxis In ICU
Funder
National Health and Medical Research Council
Funding Amount
$2,955,164.00
Summary
Around 50,000 patients in Australian Intensive Care Units receive a drug called pantoprazole each year with the aim of preventing bleeding from the gut. Recent research suggests this practice is ineffective and may harm patients by increasing their risk of serious infections. We will perform a definitive study to determine whether the widespread use of pantoprazole is beneficial or harmful.