Intensive Care Services
The RPA Intensive Care Service (ICS) is committed to clinical research. The ICS conducts and participates in research activities at a local, national and international level. Our participation in clinical research exerts a positive influence on the quality of care for all of the critically ill adults that we care for. The ICS has an active local research program, and also makes a prolific contribution to investigator-initiated randomised clinical trials in intensive care medicine via its membership of the Australian and New Zealand Intensive Care Society Clinical Trials Group (ANZICS CTG).
Highlights of recently completed and ongoing research activity include:
- ECMO. RPAH is one of the few hospitals in Australia which provides an Extracorporeal Membrane Oxygenation (ECMO) service. The ICS, in collaboration with the Cardiology, Anaesthetics and Cardiothoracic Surgery Departments, has established an ECMO research program to further refine this advanced form of life support. Recruitment to the HELP-ECMO Trial, a pilot study in a program of research to determine the optimal approach to anticoagulation of the ECMO circuit, was completed earlier this year. The efficacy of a mechanical CPR and ECMO strategy in patients with refractory cardiac arrest is currently being evaluated in the 2CHEER Study.
- SEPSIS. Severe sepsis is a major problem, and remains one of the most common reasons that patients require admission to ICU. The ICS is currently participating in a large, multi-national clinical trial evaluating the use of corticosteroids in sepsis (ADRENAL).
- BLOOD TRANSFUSION. TRANSFUSE-RCT is a multi-centre randomised controlled trial investigating whether critically ill ICU patients may benefit from receiving the freshest available blood, compared to usual practice.
- NUTRITION. Nutrition therapy is an area of ongoing research to determine the most appropriate substrates, timing, route, energy requirement assessment, and optimal nutritional goals in critically ill patients. The ICS is about to commence recruitment to the TARGET Nutrition Trial. TARGET is a multi-centre randomised controlled trial aiming to determine if augmentation of calorie delivery using energy dense enteral nutrition in mechanically ventilated patients improves 90 day survival when compared to routine care.
- RENAL REPLACEMENT THERAPY. The STARRT-AKI Trial is a multi-national clinical trial aiming to determine whether immediate initiation of renal replacement therapy (RRT), compared to a delayed approach to RRT initiation, improves survival and renal recovery (RRT independence) at 90 days in critically ill patients with severe AKI.
- ADVANCED MECHANICAL VENTILATION. The aim of the PHARLAP Study is to investigate the clinical efficacy of a comprehensive open lung strategy compared to standard mechanical ventilation in patients with ARDS. This study is currently recruiting.
- 2015 AuSPEN Bob McMahon prize for clinical research study on parenteral nutrition, awarded to Suzie Ferrie, Critical Care Dietitian.
- A/Prof David Gattas: Director of Research, Principal Investigator, Co-investigator
- Ms Heidi Buhr: Research Manager, Principal Investigator, Co-investigator
- Ms Debra Hutch: Research Coordinator, Co-investigator
Publications and Presentations
- Ferrie S. Feasibility, safety and outcome of very early enteral nutrition in critically ill patients: results of an observational study. Journal of Critical Care 2015; 30(5): 1145.
- Ferrie S. Home PEG feeds: feeding failure. Australian Doctor May 1, 2015.
- Ferrie S. Milking the market: are you pouring additives on your cereal? The Conversation, January 15, 2015. Available at: http://theconversation.com/milking-the-market-are-you-pouring-additives-on-your-cereal-33592.
- Ferrie S. Pancreatic insufficiency: an absorbing struggle. Australian Doctor January 23, 2015.
- Ferrie S. Parkinson's Disease: difficult to swallow. Australian Doctor August 21, 2015.
- Gattas DJ, Rajbhandari D, Bradford C, Buhr H, Lo S, Bellomo R. A randomised controlled trial of regional citrate versus regional heparin anticoagulation for continuous renal replacement therapy in critically ill adults. Crit Care Med 08/2015;43(8):1622-9. doi: 10.1097/CCM.0000000000001004
- Gattas D, Åneman A. The consistent inconsistency of fluid challenges in the ICU: We should reflect on extreme variation in our practice. Intensive Care Med. 2015 Sep;41(9):1670-2. doi: 10.1007/s00134-015-3961-4. Epub 2015 Jul 11. PubMed PMID: 26162678.
- Gatward JJ, O'Leary MJ, Sgorbini M, Phipps PR. Are potential organ donors missed on general wards? A 6-month audit of hospital deaths. Med J Aust. 2015 Mar 2;202(4):205-8.
- Hodgson C, Bellomo R, Berney S, Bailey M, Buhr H, Denehy L, Harrold M, Higgins A, Presneill J, Saxena M, Skinner E, Young P, Webb S, The TEAM Study Investigators. Early mobilization and recovery in mechanically ventilated patients in the ICU: a bi-national, multi-centre, prospective cohort study. Critical Care 01/2015; 19:81. DOI:10.1186/s13054-015-0765-4
- Macdonald P, Verran D, O'Leary M, Cavazzoni E, Dhital K. Heart transplantation from donation after circulatory death donors. Transplantation. 2015 Jun;99(6):1101-2. doi: 10.1097/TP.0000000000000791.
- Murgo M, Cavanagh K, Latham S (2015). Health Related Quality of Life and support needs for sub-arachnoid haemorrhage survivors in New South Wales Australia. Australian Critical Care. doi:10.1016/j.aucc.2015.07.005
- Ridley EJ, Davies AR, Robins EJ, et al. Nutrition therapy in adult patients receiving extracorporeal membrane oxygenation: a prospective, multicentre, observational study. Critical Care and Resuscitation 2015; 17(3):183-189.
- Suzuki S, Eastwood GM, Bailey M, Gattas D, Kruger P, Saxena M, Santamaria JD, Bellomo R. Paracetamol therapy and outcome of critically ill patients: a multicenter retrospective observational study. Crit Care. 2015 Apr 13;19:162. doi: 10.1186/s13054-015-0865-1. PubMed PMID: 25879463; PubMed Central PMCID: PMC4411740.
- Wang AY, Bellomo R, Cass A, Finfer S, Gattas D, Myburgh J, Chadban S, Hirakawa Y, Ninomiya T, Li Q, Lo S, Barzi F, Sukkar L, Jardine M, Gallagher MP; POST-RENAL Study Investigators and the ANZICS Clinical Trials Group. Health-related quality of life in survivors of acute kidney injury: The Prolonged Outcomes Study of the Randomized Evaluation of Normal versus Augmented Level Replacement Therapy study outcomes. Nephrology (Carlton). 2015 Jul;20(7):492-8. doi: 0.1111/nep.12488. PubMed PMID: 25891297.
- Nichol A, French C, Little L, Haddad S, Presneill J, Arabi Y, Bailey M, Cooper DJ, Duranteau J, Huet O, Mak A, McArthur C, Pettilä V, Skrifvars M, Vallance S, Varma D, Wills J, Bellomo R; EPO-TBI nvestigators; ANZICS Clinical Trials Group. Erythropoietin in traumatic brain injury (EPO-TBI): a double-blind randomised controlled trial. Lancet. 2015 Dec 19;386(10012):2499-506. doi: 10.1016/S0140-6736(15)00386-4. Epub 2015 Oct 6. PubMed PMID: 26452709.
- Sundararajan K, Flabouris A, Thompson C, Seppelt I; George Institute of Global Health; Australian and New Zealand Intensive Care Society Clinical Trials Group Point Prevalence Study Investigators. Hospital overnight and evaluation of systems and timelines study: A point prevalence study of practice in Australia and New Zealand. Resuscitation. 2016 Mar;100:1-5. doi: 10.1016/j.resuscitation.2015.11.029. Epub 2015 Dec 31. PubMed PMID: 26748146.
- Young P, Saxena M, Bellomo R, Freebairn R, Hammond N, van Haren F, Holliday M, Henderson S, Mackle D, McArthur C, McGuinness S, Myburgh J, Weatherall M, Webb S, Beasley R; HEAT Investigators; Australian and New Zealand Intensive Care Society Clinical Trials Group. Acetaminophen for Fever in Critically Ill Patients with Suspected Infection. N Engl J Med. 2015 Dec 3;373(23):2215-24. doi: 10.1056/NEJMoa1508375. Epub 2015 Oct 5. PubMed PMID: 26436473.
- Ferrie S. Managing diarrhoea during enteral feeding in ICU. In: Diet and Nutrition in Critical Care, Ed. Rajkumar Rajendram, Vinood B. Patel, Victor R. Preedy. London: Springer, 2015. ISBN: 978-1-4614-7837-9
- Ferrie S. Protein intake in critically ill patients. In: Diet and Nutrition in Critical Care, Ed. Rajkumar Rajendram, Vinood B. Patel, Victor R. Preedy. London: Springer, 2015. ISBN: 978-1-4614-7837-9.
- Ferrie S, Allman-Farinelli M, Daley M, Smith K. Australasian Society for Parenteral and Enteral Nutrition (AuSPEN) Annual Scientific Meeting: Abstract accepted for oral presentation 2015 ('Protein requirements in the critically ill: a randomised controlled trial').( Presented by Suzie Ferrie)
- Freeman-Sanderson A. 'An intervention to allow early speech in ventilated tracheostomy patients in an Australian intensive care unit (ICU): a randomised controlled trial', accepted for oral presentation at Australian and New Zealand Intensive Care Society (ANZICS) Conference, Auckland NZ, October 2015.
- Freeman-Sanderson A. 'An intervention to allow early speech in ventilated tracheostomy patients in an Australian Intensive Care unit (ICU): a randomized controlled trial', Poster presentation American Thoracic Society Conference, Denver USA, 2015.
- Freeman-Sanderson A. 'Change in quality of life with return of voice for tracheostomy patients in intensive care: an observational study', Poster presentation American Thoracic Society Conference, Denver USA, 2015.
- Freeman-Sanderson A. 'Loss of voice in mechanically ventilated tracheostomy patients: the patient experience', accepted for oral presentation at Australian and New Zealand Intensive Care Society (ANZICS) Conference, Auckland NZ, October 2015.
- Gattas D. Invited expert pannelist: Global Journal Club. Oct 2015 ANZICS ASM Auckland.
- O'Leary M. 'The high dependency unit: what is its role?' 3rd Singapore-ANZICS Intensive Care Forum, April 2015, Singapore.
- O'Leary M. 'Can we ever win the fight against the world's oldest killer?' 3rd Singapore-ANZICS Intensive Care Forum, April 2015, Singapore.
- O'Leary M. 'ICU and Organ Donation' 18th Scientific Meeting of the Malaysian Society of Transplantation, June 2015, Kuala Lumpur.
- O'Leary M. 'Intensive care management of the non-heart beating donor: The Controversies'. 18th Scientific Meeting of the Malaysian Society of Transplantation, June 2015, Kuala Lumpur.
- O'Leary M. 'Muscle Wasting and Weakness in Critical Illness'. World Congress of Intensive and Critical Care Medicine, August 2015, Seoul, South Korea.
- O'Leary M. 'How Early Is 'Early' in Enteral Nutrition?'. World Congress of Intensive and Critical Care Medicine, August 2015, Seoul, South Korea.
- O'Leary M. 'Prognostication in hypoxic-ischaemic brain injury'. ANZICS-ACCCN Annual Scientific Meeting on Intensive Care, October 2015, Auckland NZ.
- Ferrie S. DAA Nutrition Support Interest Group (NSW Chapter) 'Nutrition Support for Beginners' workshop presenter, Sydney, June 2015.
- Freeman-Sanderson A. 'An intervention to allow early speech in ventilated tracheostomy patients in an Australian intensive care unit (ICU): a randomised controlled trial', Oral presentation as SLHD Allied Health Research Forum, Sydney, December 2015.
- Freeman-Sanderson A . 'Care of the voiceless tracheostomy patient', Presented at the NSW Tracheostomy and Critical Care EBP group, 2015.
- Freeman-Sanderson A. 'Loss of voice in mechanically ventilated tracheostomy patients: the patient experience', Oral presentation as SLHD Allied Health Research Forum, Sydney, December 2015.
- Gattas D. 'Fluid Volume Strategy and Clinical Trials in Intensive Care Medicine'. Feb 2015 Jobson Symposium RPA Hospital
||A/Prof David Gattas
|| “Plasma-Lyte 148® versus Saline (PLUS) Trial”
|| $ 5,984,819
|Intensive Care Foundation
||A/Prof David Gattas
||“Randomised controlled feasibility trial of conservative vs. usual fluid management in critically ill adults”
|| $ 34,000
Contact details for department
Head of Department: A/Professor Paul Phipps
Department/Unit: Intensive Care Services
Telephone: (02) 9515 7668
Facsimile: (02) 9515 5040