A Randomised Double Blinded Placebo Controlled Trial Of Adrenaline In Cardiac Arrest.
Funder
National Health and Medical Research Council
Funding Amount
$200,500.00
Summary
It is estimated that in excess of 30,000 Australians per year suffer a cardiac arrest, mostly occurring outside of hospital. This sudden and often unpredictable event commonly occurs as a result of acute heart disease, injury, drug overdose and many other illnesses which affect both males and females of all ages. Unfortunately, the survival of those suffering a cardiac arrest remains poor. Best evidence to date suggests overall survival from cardiac arrest to be in the order of about 5%. While t ....It is estimated that in excess of 30,000 Australians per year suffer a cardiac arrest, mostly occurring outside of hospital. This sudden and often unpredictable event commonly occurs as a result of acute heart disease, injury, drug overdose and many other illnesses which affect both males and females of all ages. Unfortunately, the survival of those suffering a cardiac arrest remains poor. Best evidence to date suggests overall survival from cardiac arrest to be in the order of about 5%. While the survival for those suffering cardiac arrest remains poor, the rapid initiation of cardiopulmonary resuscitation (CPR) and defibrillation has been clearly shown to improve outcome. While defibrillation and CPR have been shown to be beneficial, the use of vasoactive drugs such adrenaline has not been proven to improve survival in cardiac arrest. This is despite adrenaline being internationally recommended as first line drug therapy in the advanced life support (ALS) management of cardiac arrest. It is now well acknowledged that clinical trials need to be undertaken to determine the clinical effects of adrenaline when used for cardiac arrest. The purpose of this study is to randomise patients suffering a cardiac arrest to receive either adrenaline (according to standard ALS guidelines) or a placebo. All other care for both groups will be the same and in accordance with current ALS guidelines. In this way we will be able to determine the effects of adrenaline on outcome, particularly survival, following cardiac arrest. The study will run for three years and involve all cardiac arrests attended by the Ambulance Service in Perth.Read moreRead less
I will determine the efficacy and safety of crystalloid resuscitation fluids in conventional models of care. This is a fundamental and unresolved question in Intensive Care Medicine and will have an impact on clinical practice worldwide. I will also consolidate and enhance a series of projects to provide the next generation of clinician-researchers with high-quality research opportunities. These include projects in sepsis, traumatic brain injury, and endocrine function in critical illness.
Up to 80% of out of hospital cardiac arrest patients do not receive bystander CPR –often because those at the scene do not have the required skills. Without immediate action the condition is fatal. Through my doctoral research I aim to investigate the best methods for providing a targeted approach of training basic life support to a group at high risk of these events -cardiac patients. I plan to develop and test the feasibility of incorporating this training into cardiac rehabilitation programs.
Improving Neonatal Transition For Compromised Infants And Minimising Lung Injury
Funder
National Health and Medical Research Council
Funding Amount
$188,226.00
Summary
The projects in this proposal are designed to improve the health of newly born infants before they are born (fetal lactate blood test to assist in decision making), at birth (randomized clinical trials to provide evidence for future resuscitation guidelines) and in the first few hours following preterm birth by studying alternative methods of providing existing therapies for neonatal respiratory distress syndrome. These studies may prevent harm and allow a “Healthy start to life”.
Blood And Blood Product Transfusion In Trauma Resuscitation
Funder
National Health and Medical Research Council
Funding Amount
$98,431.00
Summary
Blood is an exceedingly scarce and expensive resource. Massive transfusions place enormous strains on blood banks. There is little consensus and a paucity of evidence on transfusion practice in major trauma. Trauma patients account for a significant proportion of all patients who receive transfusions. This project will assist with the development of more uniform guidelines for transfusion of blood products in major trauma patients based on the best evidence available and current practice.
Improving CPR Quality By Optimising The Language Used In CPR Instructions
Funder
National Health and Medical Research Council
Funding Amount
$76,365.00
Summary
A mixed methods project to determine if the quality of dispatcher assisted cardiopulmonary resuscitation (DA-CPR) can be improved by understanding and including the wording used by laypeople to describe CPR. This study will seek input from lay people through focus groups and test the effectiveness of the changes to DA-CPR instructions, with the objective to determine the impact of including these descriptions in DA-CPR instructions on the quality of CPR in a simulation study.
Monitoring Oxygen Saturation And Heart Rate In The Early Post Natal Period
Funder
National Health and Medical Research Council
Funding Amount
$344,150.00
Summary
In recent years experts have suggested that even a brief exposure to high oxygen concentrations during delivery room (DR) resuscitation is harmful. This has led to a change in our national DR resuscitation guidelines which now advise that 21% oxygen should be considered rather than 100% oxygen for infants of all gestational ages. I aim to develop evidence based guidelines for the use of pulse oximetry in the DR and early post natal period.
Rapidly giving intravenous fluid to prevent or treat shock (fluid resuscitation) is one of the commonest treatments given to critically ill patients. Current guidelines recommend crystalloid solutions but it is unknown whether any particular crystalloid is better than others. This trial will determine whether the use of one of two crystalloid fluids, saline or PlasmaLyte, reduces the risk of organ injuries, such as kidney failure, and improves patients chances of surviving critically illness.
Improving The Outcome Of Critically Ill Patients Through The Generation Of Evidence And Its Translation Into Practice
Funder
National Health and Medical Research Council
Funding Amount
$329,822.00
Summary
This research program will test new approaches to sepsis, traumatic brain injury, kidney protection, nutrition, post-operative care, sedation, cardiac arrest, and mobilisation of acutely ill patients to deliver better outcomes. Experimental research will help understand kidney injury during severe infection and develop new ways of protecting the brain during cardiac arrest. Database investigations will identify successful patterns of treatment and potential new fields of investigations.
Improving Respiratory Transition And Outcomes Of Newborn Infants
Funder
National Health and Medical Research Council
Funding Amount
$262,251.00
Summary
Effective mask ventilation is the most important intervention at birth that can reduce mortality and disability in term and preterm infants. I will develop strategies to help clinicians improve their resuscitation skills. I will also study new ways to better support babies’ transition after birth, to improve their short and long term outcomes. The results of this research will change the way newly born babies are cared for around the world.