Intensive Care Service
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 last year, and a definitive clinical trial is currently being designed. 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 multi-national clinical trial evaluating the use of corticosteroids in sepsis (ADRENAL), the largest study to examine this question to date. Recruitment to this trial has just finished.
- BLOOD PRODUCT 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. Recruitment to this trial was completed in November 2016. The CLIP Trial is a pilot multi-centre blinded randomised controlled trial of cryopreserved platelets vs. conventional liquid-stored platelets for the management of postsurgical bleeding. Cryopreservation of platelets is a promising new technology that may allow smaller or rural hospitals to provide platelet transfusion and reduce overall platelet wastage.
- 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 currently recruiting 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.
- A/Prof David Gattas, Director of Research, Principal Investigator, Co-investigator
- Ms Heidi, Buhr, Research Manager, Principal Investigator, Co-investigator
- Ms Jennifer Coles, Research Coordinator
- Mr James Wun, Research Coordinator (acting)
Publications and Presentations
- Ferrie S. Grand Rounds: Motor Neurone Disease. Australian Doctor January, 2016
- Ferrie S. Grand Rounds: Refeeding Syndrome. Australian Doctor April 15, 2016
- Ferrie S, Allman-Farinelli M, Daley M, Smith K. Protein requirements in the critically ill: a randomised controlled trial using parenteral nutrition. JPEN 2016; 40(6):795-805
- Reid DB, Chapple LS, O'Connor SN, Bellomo R, Buhr H, Chapman MJ, Davies AR, Eastwood GM, Ferrie S, Lange K, McIntyre J, Needham DM, Peake SL, Rai S, Ridley EJ, Rodgers H, Deane AM. The effect of augmenting early nutritional energy delivery on quality of life and employment status one year after ICU admission. Anaesth Intensive Care. 2016 May;44(3):406-12
- Tipping CJ, Bailey MJ, Bellomo R, Berney S, Buhr H, Denehy L, Harrold M, Holland A, Higgins AM, Iwashyna TJ, Needham D, Presneill J, Saxena M, Skinner EH, Webb S, Young P, Zanni J, Hodgson CL. The ICU Mobility Scale has Construct and Predictive Validity and is Responsive: A Multicenter Observational Study. Ann Am Thorac Soc. 03/2016 [Epub ahead of print] DOI: 10.1513/AnnalsATS.201510-717OC
- Hodgson CL, Bailey M, Bellomo R, Berney S, Buhr H, Denehy L, Gabbe B, Harrold M, Higgins A, Iwashyna TJ, Papworth R, Parke R, Patman S, Presneill J, Saxena M, Skinner E, Tipping C, Young P, Webb S, The TEAM Study Investigators. A Binational Multicenter Pilot Feasibility Randomized Controlled Trial of Early Goal-Directed Mobilization in ICU. Crit Care Med 03/2016 [Epub ahead of print] DOI: 10.1097/CCM.0000000000001643
- Myra Sgorbini with Alvaro C, McKay L & Treloggen J. Chapter 54: Organ & Tissue Donation, in Emergency and Trauma Care for Nurses and Paramedics 2e 2016, Ed. Curtis K & Ramsden C. Elsevier Sydney
- Rashid N, Sgorbini M. Effects of a potential deceased organ donor's registered decision for organ donation on family consent rates in NSW hospitals. Transplant Nurses Association Conference, 2016, Adelaide, South Australia (National)
||A/Prof David Gattas
|| “Plasma-Lyte 148® versus Saline (PLUS) Trial”
|| $ 5,984,819
Contact details for department
Head of Department: A/Prof Paul Phipps
Department/Unit: Intensive Care Service
Telephone: (02) 9515 7668
Facsimile: (02) 9515 5040