Intensive Care

The Barwon Health Intensive care is an international leader in research examining bone loss after critical illness. A/Prof Neil Orford is the Chief Investigator for the multicentre, MRFF funded ($1,905,282.70) BONE ZONE Trial. This trial is examining the effect of zoledronic acid or denosumab in critically ill women and men. https://www.monash.edu/medicine/sphpm/anzicrc/research/bone-zone

Outcomes of patients admitted to intensive care with haematological malignancies in an Australian tertiary hospital; a retrospective 10 year audit. This ongoing audit has identified that the outcomes of this group of patients is similar to internationally published data.

What is not known or understood is the experience of critical illness for this group of patients. As part of a higher degree qualification Allison plans to explore this area by undertaking a qualitative research project to explore this phenomena from the viewpoint of patients, their families and the ICU healthcare professionals.

It is hoped that this will inform the development of further research focussing on patient experience, person centred care and shared decision making.

• Randomised embedded, multifactorial adaptive platform trial for community-acquired pneumonia (REMAP-CAP)
• A comprehensive national registry on the treatment and outcomes of patients requiring ECMO (EXCEL)
• Blend to Limit oxygen in ECMO: a randomised controlled registry trial (BLENDER)
• Bone loss prevention with Zoledronic Acid or Denosumab in critically ill women (BONE-ZONE)
• Re-evaluating the inhibition of stress erosions and prophylaxis against gastrointestinal bleeding in the critically ill (REVISE)
• The effect of augmented administration of enteral protein to crucially ill adults on clinical outcomes (TARGET Protein)
• Treatment of invasively ventilated adults with early activity and mobilisation (TEAM)
• Targeted therapeutic mild hypercapnia after resuscitated cardiac arrest: A phase III multi‐centre randomised controlled trial (TAME) https://www.nejm.org/doi/full/10.1056/NEJMoa2214552
• Liberal Glucose Control in Critically Ill Patients with pre-existing type 2 diabetes (LUCID)
• Continuous beta-lactam infusion compared with intermittent beta-lactam dosing in critically ill patients (BLING-III)
• ANZICS Point Prevalence Program (PPP)
• 20% Human albumin solution fluid bolus administration therapy in patients after cardiac surgery (HAS FLAIR)
• The mega randomised registry trial comparing conservative vs liberal oxygen targets (Mega-ROX)
• Short period incidence study of severe acute respiratory infection (SPRINT-SARI)
• Effect of denosumab on bone turnover markers in critically ill women (SOFTER)
• International point prevalence study of intensive care unit transfusion practices status (INPUT)
• Extracorporeal membrane oxygenation for 2019 novel coronavirus acute respiratory disease (ECMO CARD)
• Intensive nutrition therapy compared to usual care in critically ill adults (INTENT)

• Identifying values, listening and advising high-risk patients in acute care (i-Validate)
• The epidemiology and outcomes of patients admitted to the Intensive Care Unit with an acute mental health disorder
• Factors associated with long-term survival after critical illness
• Defining patient-centred recovery after critical illness – a qualitative study
• Neuro-prognostication in Hypoxic Ischaemic Encephalopathy
• Frailty and Intensive Care outcome

Mortality rates of patients managed in an intensive care unit (ICU) have been decreasing, and now 90% of patients survive to leave hospital.  While this is encouraging, we know relatively little about the health status of survivors of critical illness and their experience of ICU.  Some research has investigated long-term outcomes of critically ill patients, but this has included only a small proportion of patients managed in ICU.  We are planning to systematically determine the extent of patient recovery and obtain feedback from all survivors of critical illness.  This will provide important insight into long-term outcomes, and help us understand what clinical services ICU patients may require.